Balen A H, Conway G S, Kaltsas G, Techatrasak K, Manning P J, West C, Jacobs H S
Department of Endocrinology, University College London Medical School, Middlesex Hospital, UK.
Hum Reprod. 1995 Aug;10(8):2107-11. doi: 10.1093/oxfordjournals.humrep.a136243.
The criteria for the diagnosis of the polycystic ovary syndrome (PCOS) have still not been agreed universally. A population of 1741 women with PCOS were studied, all of whom had polycystic ovaries seen by ultrasound scan. The frequency distributions of the serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and prolactin and the body mass index, ovarian volume, uterine cross-sectional area and endometrial thickness were determined and compared with the symptoms and signs of PCOS. Obesity was associated with hirsutism and an elevated serum testosterone concentration and was also correlated with increased rates of infertility and cycle disturbance. The rates of infertility and cycle disturbance also increased with serum LH concentrations > 10 IU/l. A rising serum concentration of testosterone [mean and 95th percentiles 2.6 (1.1-4.8) nmol/l] was associated with an increased risk of hirsutism, infertility and cycle disturbance. The ovarian volume was correlated with serum concentrations of testosterone, LH and the body mass index, which was also correlated with the uterine area. This descriptive data from the largest reported series of women with PCOS enables the development of a management-orientated approach to the syndrome. Women who are overweight can expect an improvement in their symptoms if they lose weight. An elevated concentration of LH (> 10 IU/l) is associated with infertility and treatment should be chosen accordingly. If the serum testosterone concentration is > 4.8 nmol/l, other causes of hyperandrogenism should be excluded.
多囊卵巢综合征（PCOS）的诊断标准尚未得到普遍认可。对1741名患有PCOS的女性进行了研究，所有这些女性经超声扫描均显示有多囊卵巢。测定了血清促卵泡激素（FSH）、促黄体生成素（LH）、睾酮和催乳素浓度以及体重指数、卵巢体积、子宫横截面积和子宫内膜厚度的频率分布，并与PCOS的症状和体征进行了比较。肥胖与多毛症和血清睾酮浓度升高有关，也与不孕率和月经周期紊乱率增加相关。当血清LH浓度>10 IU/l时，不孕率和月经周期紊乱率也会增加。血清睾酮浓度升高[平均值和第95百分位数为2.6（1.1 - 4.8）nmol/l]与多毛症、不孕和月经周期紊乱风险增加有关。卵巢体积与血清睾酮、LH浓度以及体重指数相关，体重指数也与子宫面积相关。这些来自已报道的最大系列PCOS女性的描述性数据有助于制定针对该综合征的以管理为导向的方法。超重女性如果体重减轻，其症状有望改善。LH浓度升高（>10 IU/l）与不孕相关，应据此选择治疗方法。如果血清睾酮浓度>4.8 nmol/l，应排除其他高雄激素血症的原因。
