多囊卵巢综合征。

Polycystic ovary syndrome.

机构信息

Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, 1120 15th Street, CB-2209, Augusta, Georgia 30912, USA.

Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.

出版信息

Nat Rev Dis Primers. 2016 Aug 11;2:16057. doi: 10.1038/nrdp.2016.57.

DOI:10.1038/nrdp.2016.57

PMID:27510637

Abstract

Polycystic ovary syndrome (PCOS) affects 5-20% of women of reproductive age worldwide. The condition is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology (PCOM) - with excessive androgen production by the ovaries being a key feature of PCOS. Metabolic dysfunction characterized by insulin resistance and compensatory hyperinsulinaemia is evident in the vast majority of affected individuals. PCOS increases the risk for type 2 diabetes mellitus, gestational diabetes and other pregnancy-related complications, venous thromboembolism, cerebrovascular and cardiovascular events and endometrial cancer. PCOS is a diagnosis of exclusion, based primarily on the presence of hyperandrogenism, ovulatory dysfunction and PCOM. Treatment should be tailored to the complaints and needs of the patient and involves targeting metabolic abnormalities through lifestyle changes, medication and potentially surgery for the prevention and management of excess weight, androgen suppression and/or blockade, endometrial protection, reproductive therapy and the detection and treatment of psychological features. This Primer summarizes the current state of knowledge regarding the epidemiology, mechanisms and pathophysiology, diagnosis, screening and prevention, management and future investigational directions of the disorder.

摘要

多囊卵巢综合征（PCOS）影响全球 5-20%的育龄妇女。其特征是高雄激素血症、排卵功能障碍和多囊卵巢形态（PCOM）——卵巢过度产生雄激素是 PCOS 的一个关键特征。在绝大多数受影响的个体中，都存在以胰岛素抵抗和代偿性高胰岛素血症为特征的代谢功能障碍。PCOS 会增加 2 型糖尿病、妊娠糖尿病和其他与妊娠相关的并发症、静脉血栓栓塞、脑血管和心血管事件以及子宫内膜癌的风险。PCOS 是一种排除性诊断，主要基于高雄激素血症、排卵功能障碍和 PCOM 的存在。治疗应根据患者的症状和需求进行调整，通过生活方式改变、药物治疗以及可能的手术来治疗和管理超重、雄激素抑制和/或阻断、子宫内膜保护、生殖治疗以及检测和治疗心理特征，以针对代谢异常。本专题概述了该疾病的流行病学、发病机制和病理生理学、诊断、筛查和预防、治疗以及未来研究方向的现有知识。