Conway G S, Kaltsas G, Patel A, Davies M C, Jacobs H S
Department of Medicine, University College London Hospitals, United Kingdom.
Fertil Steril. 1996 Feb;65(2):337-41. doi: 10.1016/s0015-0282(16)58095-9.
To characterize women with idiopathic premature ovarian failure (POF) by their ovarian ultrasonographic appearances to establish the prevalence of follicular activity and relationship to autoimmunity, estrogen status, and historical background.
Retrospective analysis of clinical, endocrine, autoimmune, ultrasonographic, and bone densitometry parameters.
Reproductive Endrocrinology Clinics of The Middlesex Hospital, London, United Kingdom.
Data from 135 women with idiopathic POF were analyzed. A reference group of 18 women with normal ovarian function, studied in their follicular phase, was used for comparison of endocrine and ultrasound data. A reference group of 57 women with normal ovarian function was used for comparison of bone densitometry measurements.
Serum E2 concentrations, autoantibody screen, ultrasonographic measures of ovarian volume, uterine cross-sectional area and endometrial thickness and dual roentgenogram bone mineral densitometry of the lumbar spine.
The detection of ovaries by ultrasound (in 76%) and follicular activity (in 60% of patients) was associated with higher bone mineral density compared with women in whom ovaries could not be identified. Of 13 patients presenting with primary amenorrhea, ultrasonography identified ovaries in 62% and follicles in 38% whereas 38% had positive autoimmunity. Evidence of autoimmunity was found in 31% of patients overall and these were indistinguishable from the nonautoimmune remainder in every respect.
Ovarian follicular activity, previously considered to be rare, as in the "resistant ovary syndrome," is found in the majority of women with POF using pelvic ultrasonography. Patients presenting with primary amenorrhea have a similar degree of ovarian function, determined by ultrasound, and autoimmunity as those presenting with secondary amenorrhea. The role of autoimmunity in the pathogenesis of POF is not distinguished from nonautoimmune ovarian damage by the measurements made in this study.
通过卵巢超声表现对特发性卵巢早衰（POF）女性进行特征描述，以确定卵泡活性的患病率及其与自身免疫、雌激素状态和病史背景的关系。
对临床、内分泌、自身免疫、超声和骨密度测量参数进行回顾性分析。
英国伦敦米德尔塞克斯医院生殖内分泌诊所。
分析了135例特发性POF女性的数据。选取18例处于卵泡期的卵巢功能正常女性作为参照组，用于比较内分泌和超声数据。选取57例卵巢功能正常女性作为参照组，用于比较骨密度测量结果。
血清雌二醇（E2）浓度、自身抗体筛查、卵巢体积、子宫横截面积和子宫内膜厚度的超声测量以及腰椎双能X线骨密度测量。
与未发现卵巢的女性相比，超声检查发现卵巢（76%）和卵泡活性（60%的患者）的女性骨密度更高。在13例原发性闭经患者中，超声检查发现62%有卵巢，38%有卵泡，而38%有自身免疫阳性。总体上31%的患者有自身免疫证据，且这些患者在各方面与非自身免疫患者无差异。
使用盆腔超声检查发现，大多数POF女性存在卵巢卵泡活性，而此前认为这种情况如“抵抗性卵巢综合征”一样罕见。原发性闭经患者经超声检查确定的卵巢功能和自身免疫程度与继发性闭经患者相似。本研究中的测量结果未区分自身免疫在POF发病机制中的作用与非自身免疫性卵巢损伤。
