多囊卵巢综合症课件.ppt

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1、PolycysticOvarySyndrome9/2/2021IntroductionPCOSistheabbreviationpolycysticovarysyndromePCOSisamultifactorialpathogenisisandclinicalmanifestationinwomenPCOSisanendocrinedysfunction,specificallyabnormalandrogenandmetabolism.9/2/2021Etiology&Pathopysiology1.Abnormalgonadotropinsecre

2、tion2.HypersecretionofandrogensDisruptsfolliclematuration3.Insulinresistance,Elevatedinsulinlevels9/2/2021PathologyOvaries:enlargedand/orpolycysticovariesendometrium:Lackofovulationforanextendedperiodoftimemaycauseexcessivethickeningoftheendometrium9/2/2021Pathology9/2/2021Sympto

3、msIrregularorLackofMenses9/2/2021SymptomsHirsutismExcessivebodyhair.Coarsehairappearontheface,neck,chest,arms,andinbetweenthelegs.9/2/2021Symptomsmorbidobesity.9/2/2021SymptomsAcneMoreandrogencausedskinoilsandblockedporesandmoreacnearoundthejawline,armsandchest.9/2/2021SymptomsAl

4、opeciaThinningorlossofhairisusuallycontainedtotopofthescalp,butotherslossofhairinfrontoronthehairlinehasbeendocumented.9/2/2021OtherSymptomsAcanthosisNigricansThisconditioncauseslightbrowntoblackroughpatchesaroundtheneckandunderarms.9/2/2021OtherSymptomsMigrainesSevereheadachesth

5、atcauselightsensitivity,nauseaanddizziness.9/2/2021DiagnosisBBT(basalbodytemperature)Bultrasound:multiplesmallovariancystsenlargedovaryEndometriumbiopsybeforemensesrevealtoproliferativeglandsDeterminationofLH,FSH,E2,P,T,PRL，Ins，(LH:FSH≧3:1)Laparoscopy9/2/2021TreatmentIfpregnancyi

6、sdesired----causeovulationanti-estrogens(CC)Gonadotropins(Gn)insulin-loweringagents(MET)anti-androgensgonadotropinreleasinghormoneagonists(GnRHa)9/2/2021IfpregnancyisnotdesiredToreducetheriskofendometrialcancercyclicalprogesterone(MPA)insulin-loweringagents(MET)anti-androgens.Tre

7、atment9/2/2021LongTermEffects:InfertilityManywomenexperienceinfertilitywhilehavingPCOS.Manywillhavetogotoanfertilitydoctortoconceive.ToconceivewomenwithPCOShavetolearntomonitorovulationbytakingtheirBasalBodyTemperature(BBT)andexaminingcervicalmucus.9/2/2021LongTermEffects:HeartDi

8、seaseThereisnewevidencethatfindswomenwit