中文摘要：

多囊卵巢综合症是妇产科最常见和最复杂的生殖内分泌疾病,本文研究不同类型的多囊卵巢综合征患者雄激素代谢的差异,从而探讨多囊卵巢综合征（PCOS）Rotterdam标准的不同诊断指标,对我国患者卵巢雄激素合成的影响,具有重要的理论意义和临床应用意义.用尿促性素（150 IU）和绒促性素（5000 IU）,对8例正常对照组、PCOS患者的17例多囊组（Ⅰ组）、14例高雄组（Ⅱ组）和21例复合组（Ⅲ组）妇女行卵巢兴奋试验,观察孕酮、17羟孕酮和雄烯二酮的血浓度的变化,并计算雄激素合成关键酶-17α羟化酶和17,20裂解酶的功能状态和活性.PCOS的Ⅲ组和Ⅱ组的雄激素合成酶均亢进,以前者更加明显;PCOS的Ⅰ组和正常对照组的雄激素合成酶相似,基本正常.PCOS的单纯卵巢多囊形态学并无雄激素合成的异常,但综合分析,仍可诊断为PCOS,Rotterdam标准适用我国患者.

英文摘要：

Polycystic ovary syndrome（PCOS） is a disorder that affects approximately 5%10% of reproductive aged women and is characterized by excess androgen production and infertility.Despite substantial effort to define the cause of PCOS,its pathophysiology remains poorly understood.The pathophysiology of PCOS have implicated primary defects in hypothalamic-pituitary function,ovarian activity,and insulin action,but none of these can comfortably accommodate the multiple abnormalities associated with PCOS.This state of relative confusion actually reflects the complexity of the disorder.To assess the differences in androgen production among women with different aspects of Rotterdam standard for diagnosis of PCOS.The responses of serum progesterone（P）,17-hydroxyprogesterone（17OHP） and androstedione（A） were evaluated during ovarian stimulation test by menotrophins（150IU） and chrionic gonadotrophin（5000IU） in women of controls（n=8） and PCOS with main features of polycystic ovary（Group 1,n=17）,hyperan drogenism（Group 2,n=14） and both（Group 3,n=22）.The ratios of 17OHP to P and A to 17OHP at all time points during test were used as the functional index of both arms of cytochrome 450c17α,namely 17α-hydroxylase and 17,20 lyase in ovarian thecal cells.Amplified androgenic potentials were observed in ovarian thecal compartment in both groups 3 and 2 of women with PCOS,with a higher extent in the former.In contrast,comparable level of androgen production exists between PCOS group 1 and control group.Polycystic ovary appearance in Chinese women with PCOS presents normal androgen potentials,suggesting that the Rotterdam standard is suitable for Chinese PCOS diagnosis.