降雄治疗
Abstract:
Abstract:The clinical features of hyperandrogenism (HA) in PCOS include elevated serum bioactive androgen level, and some HA signs, such as acne,hirsutism,Seborrhoeic dermatitis,alopecia, etc. HA of PCOS mainly due to the accentuated secretion of pituitary LH / hyperinsulinism caused by IR. The diagnosis of PCOS HA depends on clinical symptoms/signs and serum detection, meanwhile other diseases with HA should be excluded. The selection of drug should be based on hormonal cause of HA and patients’ therapeutic needs.
Key words:
PCOS,
hyperandrogenism,
diagnosis and differentiation,
anti-androgen
[1］ Blank SK, McCartney CR, Marshall JC. The origins and sequelae of abnormal neuroendocrine function in polycystic ovary syndrome[J]. Hum Reprod Update,2006,12(4): 351-361.
[2］ Teede HJ, Meyer C, Norman RJ. Insulin-sensitisers in the treatment of polycystic ovary syndrome[J]. Expert Opin Pharmacother, 2005,6(14):2419-2427.
[3］ Baillargeon JP, Nestler JE. Polycystic ovary syndrome: a syndrome of ovarian hypersensity to insulin?[J]. Clin Endocrinol Metab,2006,91(1):122-124.
[4］ Rosenfield RL. Ovarian and adrenal function in polycystic ovary syndrome[J]. Endocrinol Metab Clin N Am，1999，28(2): 265-293.
[5］ Poretsky L, Chandrasekher YA, Bai C, et al. Insulin receptor mediates inhibitory effect of insulin, but not of insulin-like growth factor (IGF)-I, on IGF binding protein 1 (IGFBP-1) production in human granulosa cells[J]. J Clin Endocrinol Metab，1996，81(2): 493-496.
[6］ James WD .Acne[J]. N Engl J Med,2005,352:1463-1472.
[7］ Azziz R.The evaluation and management of hirsutism[J]. Obstet Gynecol,2003,101:995-1007.
[8］ Costello MF, Shrestha B, Eden J,et al. Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review[J]. Hum Reprod ,2007,22(5):1200-1209.
[9］ Nader S,Riad-Gabriel MG, Saad MF.The effect of desogestrel-containing oral contraceptives on glucose tolerance and leptin concentrations in hyperandrogenic women[J]. J Clin Endocrinol Metab,1997,82(7):3074-3077.
[10］ Crosby PD, Rittmaster RS.Predictors of clinical response in hirsute women treated with spironolactone[J]. Fertil Steril, 1991, 55(6), 1076-1081.
[11］ Ganie MA, Khurana ML, Eunice M, et al.Comparison of Efficacy of Spironolactone with Metformin in the Management of Polycystic Ovary Syndrome: An Open-Labeled Study[J]. J Clin Endocrinol Metab,2004,89(6):2756-2762.
[12］ Velazquez E,Acosta A,Mendoesa SG. Menstrual cyclicity after metformin therapy in polycystic ovary syndrome[J].Obstet Gynecol,1997,90(3):392-395.
[13］ Siebert TI, Viola MI, Steyn DW,et al.Is metformin indicated as primary ovulation induction agent in women with PCOS?A systematic review and meta-analysis[J].Gynecol Obstet Invest，2012，73:304-313.
[14］ Eisenhardt S, Schwarzmann N, Henschel V,et al.Early effects of metformin in women with polycystic ovary syndrome: a prospective randomized, double-blind, placebo-controlled trial[J]. J Clin Endocrinol Metab,2006,91(3):946-952.
[15］ Lord JM, Flight IH,Norman RJ. Metformin in polycystic ovary syndrome: systematic review and meta-analysis[J]. Br Med J,2003,327(5):951-957.
[16］ Kashyap S, Wells GA, Rosenwaks Z. Insulin-sensitizing agentsas primary therapy for patients with polycystic ovary syndrome[J]. Hum Reprod,2004,19(11):2474-2483.
[17］ Palomba S, Falbo A, Orio F Jr, et al.Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials[J]. Fertil Steril, 2009,92(5):1646-1658.
[18］ Gilbert C, Valois M, Koren G. Pregnancy outcome after first-trimester exposure to metformin: a meta-analysis[J]. Fertil Steril, 2006,86(3):658-663.
[19］ Lautatzis ME, Goulis DG, Vrontakis M.Efficacy and safety of metformin during pregnancy in women with gestational diabetes mellitus or polycystic ovary syndrome: A systematic review[J]. 2013,Epub ahead of print.
[20］ Azziz R, Ehrmann D, Legro RS, et al. Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial[J]. J Clin Endocrinol Metab,2001,86(4):1626 1632.
[21］ Du Q, Yang S, Wang YJ, et al.Effects of thiazolidinediones on polycystic ovary syndrome: a meta-analysis of randomized placebo-controlled trials[J].Adv Ther,2012,29(9):763-774.
