多囊卵巢综合征对妊娠结局的影响研究进展

doi:10.3969/j.issn.1006-7795.2016.04.007

首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (4): 449-453.doi: 10.3969/j.issn.1006-7795.2016.04.007

多囊卵巢综合征对妊娠结局的影响研究进展

李扬璐¹, 阮祥燕^1,2, 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绝经内分泌中心, 图宾根 D-72076, 德国

收稿日期:2016-06-15 出版日期:2016-08-21 发布日期:2016-07-18
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
北京市自然科学基金（Y161011），北京市卫生系统高层次卫生技术人才（学科带头人）（2014-2-016），国家外国专家局2016年度北京市引进国外技术、管理人才项目（高外端）（20161100031），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）。

Effect of polycystic ovary syndrome on pregnancy outcomes

Li Yanglu¹, Ruan Xiangyan^1,2, Alfred O. Mueck^1,2

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

Received:2016-06-15 Online:2016-08-21 Published:2016-07-18
Supported by:
This study was supported by Natural Science Foundation of Beijing(Y161011);Beijing Municipality Health Technology High-level Talent(2014-2-016);Foreign Technical and Administrative Talent Introduction Project in 2016,State Administration of Foreign Experts Affairs,the P. R. of china(20161100031);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： 多囊卵巢综合征（polycystic ovary syndrome，PCOS）是育龄期女性最常见的内分泌及代谢紊乱性疾病之一。大多数研究认为，胰岛素抵抗、高雄激素血症和肥胖在PCOS发病过程中起重要作用。临床上观察到PCOS患者常出现妊娠期糖尿病、妊娠高血压疾病等妊娠期合并症。为此，本文对PCOS不良妊娠结局相关因素如PCOS患者卵泡和胚胎发育、子宫内膜容受性的改变以及PCOS与妊娠期合并症的关系做一综述，探讨PCOS患者孕前抗雄激素治疗对其妊娠结局的影响。

关键词: 多囊卵巢综合征, 高雄激素血症, 胰岛素抵抗, 卵泡发育, 妊娠结局

Abstract: Polycystic ovary syndrome (PCOS) is a most common endocrine and metabolic disorder in women of reproductive age. Most studies suggest that insulin resistance, hyperandrogenism and obesity play an important role in the pathophysiology of PCOS. Adverse pregnancy and neonatal outcomes, such as Gestational diabetes mellitus, pregnancy-induced hypertension, are always observed clinically. Therefore, we review the relative factors about adverse outcomes, for example, the development competence of follicles and embryos, the endometrial receptivity in PCOS women, and the relationship between PCOS and pregnancy complications, in order to investigate the effects of preconceptional anti-androgenic treatment on pregnancy outcomes.

Key words: polycystic ovary syndrome, hyperandrogenism, insulin resistance, development of follicle, pregnant outcomes

中图分类号:

R711.75

李扬璐, 阮祥燕, Alfred O. Mueck. 多囊卵巢综合征对妊娠结局的影响研究进展[J]. 首都医科大学学报, 2016, 37(4): 449-453.

Li Yanglu, Ruan Xiangyan, Alfred O. Mueck. Effect of polycystic ovary syndrome on pregnancy outcomes[J]. Journal of Capital Medical University, 2016, 37(4): 449-453.

参考文献

[1] Fauser B C, Tarlatzis B C, Rebar R W, et al. Consensus on women's health aspectsof polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group[J]. Fertil Steril, 2012,97(1):28-38.
[2] Naver K V, Grinsted J, Larsen S O, et al. Increased risk of preterm delivery and pre-eclampsia in women with polycystic ovary syndrome and hyperandrogenaemia[J]. BJOG, 2014, 121(5):575-581.
[3] Aktun H L, Yorgunlar B, Acet M, et al. The effects of polycystic ovary syndrome on gestational diabetes mellitus[J]. Gynecol Endocrinol, 2016,32(2):139-142.
[4] Qin J Z, Pang L H, Li M J, et al. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis[J]. Reprod Biol Endocrinol, 2013, 11:56.
[5] Ehrmann D A. Polycystic ovary syndrome[J]. N Engl J Med, 2005,352(12):1223-1236.
[6] Tsilchorozidou T, Overton C, Conway G S. The pathophysiology of polycystic ovary syndrome[J]. Clin Endocrinol (Oxf), 2004, 60(1):1-17.
[7] Legro R S, Castracane V D, Kaufmann R P. Detecting insulin resistance in polycystic ovary syndrome: purposes and pitfalls[J]. Obstet Gynecol Surv,2004,59(2):141-154.
[8] Bates G W Jr, Propst A M. Polycystic ovarian syndrome management options[J]. Obstet Gynecol Clin North Am, 2012,39(4):495-506.
[9] Chang R J, Cook-Andersen H. Disordered follicle development[J]. Mol Cell Endocrinol, 2013,373(1-2):51-60.
[10] Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome[J]. Hum Reprod Update,2008,14(4):367-378.
[11] Dewailly D, Catteau-Jonard S, Reyss A C, et al. Oligoanovulation and polycystic ovaries but no overt hyperandrogenism[J]. J Clin Endocrinol Metab,2006,91(10): 3922-3927.
[12] Pierre A, Peigneé M, Grynberg M, et al. Loss of LH-induced down-regulation of anti-Mullerian hormone receptor expression may contribute to anovulation in women with polycystic ovary syndrome[J]. Hum Reprod,2013,28(3):762-769.
[13] Urman B, Tiras B, Yakin K. Assisted reproduction in the treatment of polycystic ovarian syndrome[J]. Reprod Biomed Online, 2004,8(4):419-430.
[14] Kurzawa R, Ciepiela P, Baczkowski T,et al. Comparison of embryological and clinical outcome in GnRH antagonist vs GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study[J]. J Assist Reprod Genet, 2008,25(8):365-374.
[15] Jungheim E S, Schoeller E L, Marquard K L, et al. Diet-induced obesity model: abnormal oocytes and persistent growth abnormalities in the offspring[J]. Endocrinology, 2010, 151(8):4039-4046.
[16] Niu Z, Lin N, Gu R, et al. Associations between insulin resistance, free fatty acids, and oocyte quality in polycystic ovary syndrome during in vitro fertilization[J]. J Clin Endocrinol Metab, 2014, 99(11):E2269-E2276.
[17] Qiao J, Feng H L. Extra-and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence[J]. Hum Reprod Update, 2011,17(1):17-33.
[18] Giudice L C.Endometrium in PCOS: Implantation and predisposition to endocrine CA[J]. Best Pract Res Clin Endocrinol Metab, 2006, 20(2):235-244.
[19] Taylor A H, Guzail M, Wahab M, et al. Quantitative histomorphometric analysis of gonadal steroid receptor distribution in the normal human endometrium through the menstrual cycle[J]. Histochem Cell Biol, 2005,123(4-5):463-474.
[20] Villavicencio A, Bacallao K, Avellaira C, et al. Androgen and estrogen receptors and co-regulators levels in endometrial from patients with polycystic ovarian syndrome with and without endometrial hyperplasia[J].Gynecol Oncol, 2006, 103(1):307-314.
[21] Berstein L M,Kvatchevskaya J O,Poroshina T E, et al. Insulin resistance, its consequences for the clinical course of the disease, and possibilities of correction in endometrial cancer[J]. J Cancer Res Clin Oncol, 2004, 130(11): 687-693.
[22] 翟军,孙莹璞,刘春喜,等. 二甲双胍治疗对PCOS 患者子宫内膜胰岛素抵抗的影响[J].河南医学研究,2012, 21(1):26-31.
[23] Wang Y, Zhao X, Zhao H, et al. Risks for gestational diabetes mellitus and pregnancy-induced hypertension are increased in polycystic ovary syndrome[J]. Biomed Res Int, 2013, 2013:182582.
[24] Chen M J, Yang W S, Yang J H, et al. Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome[J]. Hypertension, 2007,49(6):1442-1447.
[25] Naver K V, Grinsted J, Larsen S O, et al. Increased risk of preterm delivery and pre-eclampsia in women with polycystic ovary syndrome and hyperandrogenaemia[J]. BJOG, 2014,121(5):575-581.
[26] 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.
[27] Ecklund L C, Usadi R S. Endocrine and reproductive effects of polycystic ovarian syndrome[J]. Obstet Gynecol Clin North Am, 2015,42(1):55-65.
[28] Pan J X, Liu Y, Ke Z H, et al. Successive and cyclic oral contraceptive pill pretreatment improves IVF/ICSI outcomes of PCOS patients and ameliorates hyperandrogenism and antral follicle excess[J]. Gynecol Endocrinol, 2015,31(4):332-336.
[29] 卢永军,阮祥燕,田玄玄,等.多囊卵巢综合征综合治疗对妊娠结局的影响[J]. 2014,35(4):428-432.
[30] Palomba S, Falbo A, Orio F Jr, et al. Pretreatment with oral contraceptives in infertile anovulatory patients with polycystic ovary syndrome who receive gonadotropins for controlled ovarian stimulation[J]. Fertil Steril,2008,89(6):1838-1842.

多囊卵巢综合征对妊娠结局的影响研究进展

Effect of polycystic ovary syndrome 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]	李扬璐, 阮祥燕, 程姣姣, 周琦, 杜娟, 金凤羽, 谷牧青. 抗氧化剂联合应用优化人卵巢组织冻融效果的研究[J]. 首都医科大学学报, 2021, 42(4): 526-532.
[3]	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.
[4]	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.
[5]	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.
[6]	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.
[7]	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.
[8]	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.
[9]	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.
[10]	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.
[11]	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.
[12]	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.
[13]	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.
[14]	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.
[15]	黄文阳, 何鑫, 李卫华, 张雪芳, 李湛, 谷丽, 路军丽, 王淑珍. 孕期高危型人乳头瘤病毒的流行病学特征及对妊娠结局的影响[J]. 首都医科大学学报, 2018, 39(6): 836-840.