首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (4): 620-625.doi: 10.3969/j.issn.1006-7795.2025.04.006

• 更年期妇科内分泌与生育力保护 • 上一篇    下一篇

卵泡囊肿合并月经异常患者的临床特征

金婧1,阮祥燕1*,华琳2,程姣姣1,赵越1,田玄玄1   

  1. 1. 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；2.首都医科大学生物医学工程学院，北京 100069
  • 收稿日期:2024-12-24 出版日期:2025-08-21 发布日期:2025-08-29
  • 通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
  • 基金资助:
    北京市卫生健康委员会北京市研究型病房示范建设项目（BCRW202109）。

Clinical characteristics of the patients with follicular cysts and menstrual disorders

Jin Jing1, Ruan Xiangyan1*, Hua Lin2, Cheng Jiaojiao1, Zhao Yue1, Tian Xuanxuan1   

  1. 1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China;2.School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
  • Received:2024-12-24 Online:2025-08-21 Published:2025-08-29
  • Supported by:
    This study was supported  by  Beijing Municipal Health Commission, Demonstration Construction Project of Clinical Research Ward (BCRW202109).

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摘要： 目的  探讨卵泡囊肿合并月经异常患者的临床特征。方法  选取2022年8月至2024年7月在首都医科大学附属北京妇产医院内分泌科就诊的卵泡囊肿合并月经异常患者共178例，年龄23~53岁，平均（38.62±6.35）岁。并根据年龄分为3组：组1（21~30岁）共27例，组2（31~40岁）共77例，组3（>40岁）共74例。记录研究对象的年龄、月经情况，测量其身高、体质量，检测血清卵泡刺激素（follicle-stimulating hormone, FSH）、黄体生成素（luteinizing hormone, LH）、雌二醇（estradiol, E2）、孕酮（progesterone, Po）、总睾酮（total testosterone, TT）、催乳素（prolactin, PRL）、抗米勒管激素（anti-Müllerian hormone, AMH）及甲状腺功能（异常子宫出血患者同时检测血常规及凝血功能），测量卵泡囊肿的大小及子宫内膜的厚度。对卵泡囊肿合并月经异常患者的临床特征进行描述，并比较3组之间的各项指标。结果  ①61例（34.3%）患者主诉停经或闭经、117例（65.7%）患者主诉异常子宫出血、13例（7.3%）患者因异常子宫出血导致贫血，所有患者均给予药物治疗。②124例（69.7%）患者卵泡囊肿在1个月内消失，176例（98.9%）患者卵泡囊肿在2个月内消失，178例（100%）患者卵泡囊肿在3个月内消失。177例（99.4%）患者卵泡囊肿直径小于5 cm，仅1例（0.6%）患者卵泡囊肿直径≥5 cm。③卵泡囊肿合并月经异常患者卵巢储备功能减退（diminished ovarian reserve, DOR）的总体患病率为82.0%（146/178），<40岁的患者DOR的患病率为70.2%。组1、组2、组3的DOR患病率分别为37.0%（10/27），81.8%（63/77）及98.6%（73/74）。随年龄增长，DOR患病率逐渐增加。④组1、组2、组3 AMH的中位数分别为1.55 ng/mL、0.51 ng/mL、0.15 ng/mL；组3的FSH高于组1和组2（adjusted P<0.05），AMH浓度低于组1和组2（adjusted P<0.05）；组2的AMH浓度低于组1（adjusted P<0.05），差异均有统计学意义。结论  卵泡囊肿合并月经异常的患者推荐药物治疗，而不仅仅是期待治疗；卵泡囊肿合并月经异常患者DOR的患病率明显高于正常女性，即使是<40岁的女性DOR的患病率亦偏高，因此，治疗其月经异常的同时评估卵巢储备功能十分必要，尤其对有生育需求的年轻女性。

关键词: 卵泡囊肿, 功能性卵巢囊肿, 月经异常, 卵巢储备功能减退, 抗米勒管激素, 异常子宫出血, 性激素

Abstract: Objective  To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders. Methods  A total of 178 women with follicular cysts complicated by menstrual disorders were recruited, who were aged 23-53 (38.62±6.35) years and came to the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024. The participants were divided into three groups according to the age, with 27 women in the age group of 21-30 years (Group 1), 77 in the age group of 31-40 years (Group 2), and 74 in the age group of>40 years (Group 3). The age and menstruation of these patients were collected, the body height, weight, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (Po), total testosterone (TT), prolactin (PRL), anti-müllerian hormone (AMH) and thyroid function ［blood routine and blood clotting for patients with abnormal uterine bleeding (AUB) ］were measured, and the diameter of ovarian cyst and the thickness of endometrium were examined. The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups. Results  ① Among 178 patients, 61 (34.3%) patients presented with complaints of cessation of regular menstruation or amenorrhea and 117 (65.7%) with complaints of AUB. Out of 178 patients, 13 (7.3%) patients developed anemia due to AUB, and all the patients were treated with medication. ② Follicular cysts disappeared in 1 month for 124 (69.7%) patients, disappeared in 2 months for 176 (98.9%) patients, and disappeared in 3 months for 178 (100%) patients. A total of 177 (99.4%) patients had follicular cysts with a diameter less than 5 cm, and only 1 (0.6%) patient had follicular cysts with a diameter ≥ 5 cm. ③ The overall prevalence of diminished ovarian reserve (DOR) in patients with follicular cysts complicated by menstrual disorders was 82.0%, and the prevalence of DOR was 70.2% for the patients under 40 years old. The prevalence of DOR in three age groups was 37.0% (10/27), 81.8% (63/77), and 98.6% (73/74), respectively. The prevalence of DOR gradually increased with age. ④ The median AMH values for Group 1, Group 2, and Group 3 were 1.55, 0.51, and 0.15 ng/mL, respectively. The FSH level in Group 3 was significantly higher than that in Groups 1 and 2 (adjusted P<0.05), while the AMH level was significantly lower than that in Groups 1 and 2 (adjusted P<0.05). The AMH level in Group 2 was lower than that in Group 1 (adjusted P<0.05). Conclusion  Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment, rather than just expecting treatment. The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women, even in women younger than 40 years old. Therefore, it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders, particularly for young women with fertility needs.

Key words: follicular cyst, functional ovarian cyst, menstrual disorders, diminished ovarian reserve, anti-Müllerian hormone, abnormal uterine bleeding, sex hormone

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