多囊卵巢综合征患者不同临床表型的性功能分析

doi:10.3969/j.issn.1006-7795.2024.04.009

首都医科大学学报 ›› 2024, Vol. 45 ›› Issue (4): 616-622.doi: 10.3969/j.issn.1006-7795.2024.04.009

• 更年期生殖内分泌与生育力保护 • 上一篇下一篇

多囊卵巢综合征患者不同临床表型的性功能分析

田玄玄, 阮祥燕^*, 金婧, 鞠蕊, 杜娟, 程姣姣, 杨瑜

首都医科大学附属北京妇产医院/北京妇幼保健院内分泌科, 北京 100026

收稿日期:2024-05-14 出版日期:2024-08-21 发布日期:2024-07-08
通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
基金资助:
北京市医院管理中心“登峰”人才培养计划项目（DFL20181401）。

Analysis of sexual function of patients with polycystic ovary syndrome with different clinical phenotypes

Tian Xuanxuan, Ruan Xiangyan^*, Jin Jing, Ju Rui, Du Juan, Cheng Jiaojiao, Yang Yu

Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China

Received:2024-05-14 Online:2024-08-21 Published:2024-07-08
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals “Ascent Plan” (DFL20181401).

摘要/Abstract

摘要： 目的探讨多囊卵巢综合征（polycystic ovarian syndrome, PCOS）患者不同临床表型性功能及其与临床和性激素特征的相关性。方法使用女性性功能指数（Female Sexual Function Index, FSFI）调查问卷对首都医科大学附属北京妇产医院内分泌科2020年10月至2021年12月就诊的PCOS患者和对照女性进行研究。根据鹿特丹标准将PCOS分为四个临床表型组，A组：排卵功能障碍（oligo-ovulation or anovulation，OA）+雄激素过多（hyperandrogenism，HA）+多囊卵巢（polycystic ovaries，PCO）；B组：OA + HA; C组：HA+ PCO; D组：OA +PCO。收集可能影响性功能的临床资料并测定性激素水平，包括人体测量指标、血清促卵泡激素、促黄体生成素、催乳素和总睾酮。结果 910例PCOS患者和402例参数完整的对照女性纳入研究。A组FSFI总分最低（23.69±3.20）（P <0.05）， B组、C组和D组呈顺序增加的趋势。对照组FSFI总分最高（24.96±3.79）（P <0.05）。与对照组相比，A组性功能障碍（female sexual dysfunction, FSD）风险百分比最高，为87.5% （P <0.05），其次分别为B组、C组、D组。A组FSD风险高于C组和D组（P <0.05）， B组FSD风险高于D组（P<0.05）。多元线性回归分析显示总睾酮、年龄、腰围、体脂分布与女性性功能呈负相关。结论与对照组相比，PCOS患者FSD风险较高，且与PCOS临床表型相关。同时符合PCOS三个诊断特征的经典表型FSD风险最高。总睾酮、年龄、腰围、体脂分布与PCOS患者的FSD风险相关。

关键词: 多囊卵巢综合征, 性功能, 临床表型, 相关性

Abstract: Objective To investigate the sexual function of different clinical phenotypes in patients with polycystic ovarian syndrome (PCOS) and its correlation with clinical and sex hormonal characteristics. Methods The study evaluated sexual function on PCOS patients and control women in the Department of Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2020 to December 2021, via the Chinese version of Female Sexual Function Index (FSFI). PCOS were divided into four clinical phenotype groups according to the Rotterdam criteria, A: oligo-ovulation or anovulation (OA) + hyperandrogenism (HA) + polycystic ovaries (PCO); B: OA + HA; C: HA+ PCO; D: OA +PCO. The clinical data that may affect sexual function were collected and sex hormone levels were measured, including anthropometric markers, serum follicle-stimulating hormone, luteinizing hormone, prolactin and total testosterone. Results A total of 910 PCOS women and 402 control women with complete parameters were included in the study. Phenotype A had the lowest total FSFI mean score (23.69±3.20) (P <0.05); phenotype B, C and D showed a trend of sequential increase. Control group had the highest total FSFI mean score (24.96±3.79) (P <0.05). Compared with the control group, Group A had the highest risk percentage of female sexual dysfunction (FSD) at 87.5% (P <0.05), followed by Group B, Group C, and Group D. The control group had the lowest FSD risk percentage, which was 62.19% (P <0.05). The FSD risk in Group A was higher than that in Group C and Group D (P <0.05), while the FSD risk in Group B was higher than that in Group D (P <0.05). Multivariate linear regression analysis demonstrated that total testosterone (TT), age, waist circumference, and body fat distribution were negatively correlated with female sexual function. Conclusions Compared with the control group, PCOS patients have a higher risk of FSD and are associated with the clinical phenotype of PCOS. The classic phenotype that simultaneously meets the three diagnostic characteristics of PCOS has the highest risk of FSD. TT, age, waist circumference, and body fat distribution are associated with FSD risk in PCOS women.

Key words: olycystic ovary syndrome, sexual function, clinical phenotypes, correlation

中图分类号:

R711.7

田玄玄, 阮祥燕, 金婧, 鞠蕊, 杜娟, 程姣姣, 杨瑜. 多囊卵巢综合征患者不同临床表型的性功能分析[J]. 首都医科大学学报, 2024, 45(4): 616-622.

Tian Xuanxuan, Ruan Xiangyan, Jin Jing, Ju Rui, Du Juan, Cheng Jiaojiao, Yang Yu. Analysis of sexual function of patients with polycystic ovary syndrome with different clinical phenotypes[J]. Journal of Capital Medical University, 2024, 45(4): 616-622.

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多囊卵巢综合征患者不同临床表型的性功能分析

Analysis of sexual function of patients with polycystic ovary syndrome with different clinical phenotypes

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