多囊卵巢综合征(PCOS)患者的长期管理.pptx

PCOS长期管理幻灯;;PCOS是育龄妇女最常见的内分泌紊乱性疾病;PCOS患者终身存在潜在健康影响;PCOS的远期危害不容忽视;高雄导致胰岛素抵抗的机制;PCOS患者高雄导致心血管疾病;国内外均认为PCOS的远期风险需长期监控;;PCOS疾病危害重大且进行性发展——需要长期管理;PCOS长期管理具有重要意义;PCOS患者长期管理可有效预防远期并发症;PCOS长期管理的主要内容;PCOS长期管理——生活方式管理;胰岛素抵抗;对照组;PCOS长期管理——胰岛素异常管理;高雄激素血症管理——PCOS的诊治核心 既是现阶段不可忽视的重要问题，也是长期管理的关键环节;;;;Pucci E. et al. Treatment of androgen excess in females: yesterday, today and tomorrow. Gynecol Endocrin 1997; 11: 411-433Shaw. Dermatological Clinics 1996; 14: 803.;Muhn P. et al. Contraception 1995; 51: 99-110 St?lzer W. et al. Tierexperimentelle Charakterisierung des Gestagens Dienogest (STS 557). II. Antigonadotrope, gestagene, estrogene und antiandrogene Wirkungen. III Jenaer Symposium zur hormonalen Kontrazeption, 1985 Falsetti L, et al.. Human Reproduction.2001;16(1):36-42 ;(ng/ml);患者DHEAS水平与治疗前相比具有显著性差异，并持续降低。SHBG治疗后显著增高。;(mUI/ml);;醋酸环丙孕酮作用于此;Fugere P. et al. Cyproterone acetate / ethinyl estradiol in the treatment of acne. A comparativedose-response study of the estrogen component. Contraception 1990; 42: 225-234;达英-35 ?有助于更多痤疮患者恢复正常;;Gollnick et al. The efficacy of oral cyproterone acetate in combination with ethinyloestradiol in acne tarda of the facial type. Journal of Dermatological treatment 1998; 9: 71-79;;达英－35?治疗后总体Ferriman-Gallway 评分的降低率(n=63) 达英－35治疗60个周期后 (n=140) 在周期12－24后，所有痤疮病例均得到治愈 69％多毛症病例得到治愈 其中100％中度多毛症治愈 80％的严重多毛症转变为轻－中度;;治疗后月经周期恢复;Falsetti L. et al. Efficacy of the combination ethinyl estradiol and cyproterone acetate on endocrine, clinical and ultrasonographic profile in polycystic ovarian syndrome. Human Reproduction 2001; 16 (1): 36-42.;L.Falsetti, E. Pasinetti. Acta Obstet Gynecol Scand.1995;74:56-60.;;Aydinlik S. et al. Long-term therapy of signs of androgenisation with a low-dosed antiandrogen-estrogen combination. Clin Trials J 1990; 27: 392-402;Heinemann L. et al. Safety of Cyproterone Acetate: Report of Active Surveillance. Pharmacoepidemiology and Drug Safety 1997; 6: 169-178.;;;;PCOS长期管理的展望;总结;Thank you！