多囊卵巢综合征综合治疗对妊娠结局的影响

doi:10.3969/j.issn.1006-7795.2014.04.009

首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (4): 428-432.doi: 10.3969/j.issn.1006-7795.2014.04.009

• 更年期与妇科内分泌专题 • 上一篇下一篇

多囊卵巢综合征综合治疗对妊娠结局的影响

卢永军¹, 阮祥燕¹, 田玄玄¹, 刘玉兰¹, 甄洁¹, Diethelm Wallwiener², Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
2. 德国图宾根大学妇产医院内分泌与绝经中心, 德国图宾根 D-72076

收稿日期:2014-06-10 出版日期:2014-08-21 发布日期:2014-07-22
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
国家外专局引智项目（GDJ20141100017），北京市卫生系统高层次卫生技术人才培养计划项目（2009-3-52），首都医科大学附属北京妇产医院北京妇幼保健院学科带头人项目（2013-1）。

Effects of comprehensive treatment for polycystic ovary syndrome（PCOS） on pregnancy outcomes

Lu Yongjun¹, Ruan Xiangyan¹, Tian Xuanxuan¹, Liu Yulan¹, Zhen Jie¹, Diethelm Wallwiener², Alfred O. Mueck^1,2

1. Department of Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department of Endocrinology, University Women's Hospital of Tubingen, Tubingen D-72076, Germany

Received:2014-06-10 Online:2014-08-21 Published:2014-07-22
Supported by:
This study was supported by China Administration of Foreign Experts Affairs Yinzhi Project(GDJ20141100017); Beijing Municipality Health Technology High-level Talent(2009-3-52); Project of Discipline Leader, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital(2013-1).

摘要/Abstract

摘要：

目的了解多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者综合治疗后对其妊娠结局的影响。方法选取2012年8月~2014年2月就诊于首都医科大学附属北京妇产医院内分泌科被确诊为多囊卵巢综合征且有妊娠要求，并自愿签署知情同意书参加本研究项目的妇女共100例。其中根据是否需要、是否愿意服用炔雌醇环丙孕酮片达英-35和二甲双胍，分为研究组50例和对照组50例。研究组进行3个月个体化综合治疗〔达英-35和（或）二甲双胍联合生活方式调整〕。对照组则仅进行生活方式调整，观察2组的妊娠情况。结果研究组与对照组相比，2组的妊娠率比较，差异无统计学意义（P>0.05）；对照组自然流产6例，妊娠期糖尿病发生5例，妊娠期高血压发生6例；研究组自然流产3例，无妊娠期糖尿病及妊娠期高血压事件发生。2组的自然流产率比较，差异无统计学意义（P>0.05），但研究组与对照组相比自然流产率有降低的趋势。研究组的妊娠期糖尿病、妊娠期高血压发生率均低于对照组（P<0.05）。结论个体化综合治疗对多囊卵巢综合征患者的妊娠有积极作用，可在一定程度上减少妊娠不良结局（如自然流产、妊娠期糖尿病、妊娠期高血压等）的发生。

关键词: 多囊卵巢综合征, 自然流产, 妊娠期糖尿病, 妊娠期高血压

Abstract:

Objective To observe efficacy of comprehensive treatment for polycystic ovary syndrome(PCOS) on pregnancy outcomes.Methods A total of 100 patients with PCOS who were expecting to become pregnant seen in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University between August 2012 and February 2014 and signed informed consent voluntarily to participate in this research project were enrolled. According to need and willingness of participants to take Diane-35 and metformin, they were divided into observation group(n=50) and control group(n=50). The patients in observation group were treated with individualized comprehensive treatment for 3 months, which included Diane-35 and/or metformin and modification of lifestyle. Control group was only treated with modification of lifestyle. The pregnancy outcomes of two groups were observed. Results 1 The pregnancy rate of 2 groups had no significant difference(P>0.05); 2 The control group had spontaneous abortion in 6 cases, gestational diabetes mellitus in 5 cases and pregnancy induced hypertension in 6 case; the observation group developed spontaneous abortion in 3 cases and had no gestational diabetes mellitus and pregnancy induced hypertension events. The spontaneous abortion rate for two groups had no significant difference(P>0.05), but compared to control group, observation group had a tendency to have lower rate of spontaneous miscarriege. The incidence of gestational diabetes and pregnancy induced hypertension in observation group were lower than those of control group(P<0.05). Conclusion Comprehensive treatment showed a positive role in pregnancy of patients with PCOS and can reduce adverse pregnancy outcomes(e.g. spontaneous abortion, gestational diabetes mellitus, pregnancy induced hypertension) to a certain extent.

Key words: PCOS, spontaneous abortion, gestational diabetes mellitus, pregnancy induced hypertension

中图分类号:

R711.75

卢永军, 阮祥燕, 田玄玄, 刘玉兰, 甄洁, Diethelm Wallwiener, Alfred O. Mueck. 多囊卵巢综合征综合治疗对妊娠结局的影响[J]. 首都医科大学学报, 2014, 35(4): 428-432.

Lu Yongjun, Ruan Xiangyan, Tian Xuanxuan, Liu Yulan, Zhen Jie, Diethelm Wallwiener, Alfred O. Mueck. Effects of comprehensive treatment for polycystic ovary syndrome（PCOS） on pregnancy outcomes[J]. Journal of Capital Medical University, 2014, 35(4): 428-432.

参考文献

[1] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome[J]. Fertil Steril, 2004,81(1):19-25.
[2] Chen Z J, Shi Y. Polycystic ovary syndrome[J]. Front Med China, 2010,4(3):280-284.
[3] 闫雪,徐兴华,陈子江.多囊卵巢综合征对妊娠结局的影响[J].国际生殖健康/计划生育杂志,2011,30(5):371-374.
[4] Boomsma C M, Eijkemans M J, Hughes E G, et al. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome[J]. Hum Reprod Update, 2006,12(6):673-683.
[5] Li G, Fan L, Zhang L, et al. Metabolic parameters and perinatal outcomes of gestational diabetes mellitus women with polycystic ovary syndrome[J]. J Perinat Med, 2010,38(2):141-146.
[6] Homburg R. Adverse effects of luteinizing hormone on fertility: fact of fantasy[J]. Baill Clin Obstet Gynaecol, 1998,12(4):555-563.
[7] Vanky E, Stridsklev S, Skogy K, et al. PCOS-what matters in early pregnancy?-data froma cross-sectional, multicenter study[J]. Acta Obstet Gynecol Scand, 2011,90(4):398-404.
[8] Turhan N O, Seckin N C, Aybar F, et al. Assessment of FPGcose tolerance and pregnancy outcome of polycystic ovary patients[J]. Int J Gynaecol Obstet, 2003,81(2):163-168.
[9] Veltman-Verhulst S M, van Haeften T W, Eijkemans M J, et al. Sex hormone-binding globulin concentrations before conception as a predictor for gestational diabetes in women with polycystic ovary syndrome[J]. Hum Reprod, 2010,25(12):3123-3128.
[10] Kahn S M, Hryb D J, Nakhla A M, et al. Sex hormone-binding globulin is synthesized in target cells[J]. J Endocrinol, 2002,175(1):113-120.
[11] Ding E L, Song Y, Manson J E, et al. Plasma sex steroid hormones and risk of developing type 2 diabetes in women: a prospective study[J]. Diabetologia, 2007,50(10):2076-2084.
[12] Stefan N, Schick F, Hiring H U. Sex hormone-binding globulin and risk of type 2 diabetes[J]. N Engl J Med, 2009,361(12):2675-2676.
[13] Perry J R, Weedon M N, Langenberg C, et al. Genetic evidence that raised sex hormone binding globulin(SHBG) levels reduce the risk of type 2 diabetes[J]. Hum Mol Genet, 2010,19(3):535-544.
[14] Peiris A N, Stagner J I, Plymate S R, et al. Relationship of insulin secretory pulses to sex hormone-binding globulin in normal men[J]. J Clin Endoerinol Metab, 1993,76(2):279-282.
[15] Haffner S M. Sex hormone-binding protein, hyperinsulinemia, insulin resistance and noninsulin-dependent diabetes[J]. Horm Res, 1996,45(3-5):233-237.
[16] Bartha J L, Comino-Delgado R, Romem-Carmona R, et al. Sex hormone binding globulin in gestational diabetes[J]. Aeta Obstet Gynecol Scand, 2000,79(10):839-845.
[17] Smimakis K V, Plati A, Wolf M, et al. Predicting gestational diabetes: choosing the optimal early serum marker[J]. Am J Obstet Gynecol, 2007,196(4):410-416.
[18] Thadhani R, Wolf M, Hsu-Blatman K, et al. First-trimester sex hormone binding globulin and subsequent gestational diabetes mellitus[J]. Am J Obstet Gynecol, 2003,189(1):171-176.
[19] Jin Z, Guan X, Gao H, et al. The change in sex hormone binding globulin and the influence by gestational diabetes mellitus in fetal period[J]. Gynecol Endocrinol, 2009,25(10):647-652.
[20] Boomsma C M, Eijkemans M J, Hughes E G, et al. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome[J]. Hum Reprod Update, 2006,12(6):673-683.
[21] 李光辉,范玲,张为远.多囊卵巢综合征对围产结局影响的研究进展[J].中华围产医学杂志,2011,14(9):562-566.
[22] 郝明,周楠,胡兴茂,等.妊娠相关蛋白在多囊卵巢综合征早期自然流产患者的表达及临床意义[J].解放军医药杂志,2013,25(9):63-66,72.
[23] 郑璐,张涵,杜鹃.脂联素和抵抗素与妊娠期糖尿病的相关性研究[J].中国医科大学学报,2011,40(7):645-648.
[24] 陈茜松,张剑峰,胡建威,等.抵抗素和脂联素与妊娠期高血压疾病的相关性研究[J].中国煤炭工业医学杂志,2013,16(2):239-241.

多囊卵巢综合征综合治疗对妊娠结局的影响

Effects of comprehensive treatment for polycystic ovary syndrome（PCOS） on pregnancy outcomes

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	李健, 白文佩, 江波, 白栎然, 吴凤云. 生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响[J]. 首都医科大学学报, 2021, 42(6): 1021-1025.
[2]	王虎生, 阮祥燕, 程姣姣, Alfred O. Mueck. 肥胖型多囊卵巢综合征的氧化应激与脂代谢关系的研究[J]. 首都医科大学学报, 2021, 42(4): 540-546.
[3]	杨瑜, 阮祥燕, 鞠蕊, 许新, 谷牧青, 程姣姣. 屈螺酮炔雌醇Ⅱ对多囊卵巢综合征患者血清抗苗勒管激素的影响[J]. 首都医科大学学报, 2021, 42(4): 547-552.
[4]	刘真, 殷冬梅, 战思恩, 阮祥燕. 黄连素改善多囊卵巢综合征患者代谢异常的系统评价[J]. 首都医科大学学报, 2021, 42(4): 588-595.
[5]	王景尚, 尹晓丹, 何军琴, 武颖, 张莹, 李宪锐. 来曲唑联合高糖高脂饮食构建多囊卵巢综合征伴胰岛素抵抗大鼠模型研究[J]. 首都医科大学学报, 2021, 42(3): 436-442.
[6]	张黎锐, 郑薇, 刘程, 梁馨, 张莉, 田志红, 李光辉. 多囊卵巢综合征孕妇妊娠期增重模式与母儿结局的关系[J]. 首都医科大学学报, 2021, 42(2): 169-176.
[7]	闵敏, 阮祥燕, 王虎生, 程姣姣, 罗穗豫, 许仲婷, 李萌, Alfred O. Mueck. 奥利司他综合干预对超重或肥胖型多囊卵巢综合征患者代谢综合征及其组分的影响[J]. 首都医科大学学报, 2020, 41(4): 514-519.
[8]	王宾红, 阮祥燕, 鞠蕊, 豆竹丽, 秦爽, 张露平, 许新, 杨瑜, Alfred O. Mueck. 综合干预治疗对多囊卵巢综合征患者雄激素浓度的影响[J]. 首都医科大学学报, 2020, 41(4): 520-524.
[9]	豆竹丽, 阮祥燕, 鞠蕊, 王宾红, 秦爽, 许新, 杨瑜, 张露平. 综合干预后多囊卵巢综合征不孕患者应用来曲唑促排卵的临床效果[J]. 首都医科大学学报, 2020, 41(4): 525-529.
[10]	秦爽, 阮祥燕, 王宾红, 鞠蕊, 张露平, 豆竹丽, 程姣姣, 金婧. 多囊卵巢综合征患者促排卵周期中成熟卵泡性激素浓度对妊娠的影响[J]. 首都医科大学学报, 2020, 41(4): 530-535.
[11]	阮祥燕, 张露平, 代荫梅, 王虎生, 金凤羽, 谷牧青, 程姣姣, 鞠蕊, 闵敏, Thomas Roemer. 门诊微型宫腔镜检查在不孕症患者中的临床应用[J]. 首都医科大学学报, 2019, 40(4): 549-553.
[12]	谷牧青, 李扬璐, 程姣姣, 王虎生, 阮祥燕, 贾婵维. 达英-35对多囊卵巢综合征患者代谢与性激素的影响[J]. 首都医科大学学报, 2019, 40(4): 560-565.
[13]	闵敏, 阮祥燕, 赵越, 王虎生, 程姣姣, 罗穗豫, 许仲婷, 李萌, 张露平, 王月姣, Alfred O. Mueck. 奥利司他综合干预对超重或肥胖型PCOS患者雄激素及糖脂代谢的影响[J]. 首都医科大学学报, 2019, 40(4): 572-577.
[14]	杜娟, 阮祥燕, Alfred O. Mueck. 口服避孕药对多囊卵巢综合征患者性功能的影响[J]. 首都医科大学学报, 2018, 39(4): 499-504.
[15]	金婧, 阮祥燕, 华琳, 李杨璐, 王利娟, 王虎生, 赵越, Alfred O. Mueck. 多囊卵巢综合征卵巢储备功能降低患者肥胖及糖脂代谢特征[J]. 首都医科大学学报, 2018, 39(4): 505-511.