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目的分析多囊卵巢综合征(PCOS)患者的性功能与性激素及甲状腺激素的相关性。方法采用横断面研究方法,对2019年1～12月就诊北京妇产医院妇科内分泌科的PCOS患者,使用女性性功能指数量表(female Sexual Function Index, FSFI)评估性功能;测量其基本体质指标并测定基础血清性激素水平,包括卵泡刺激素(FSH)、黄体生成素(LH)、催乳素(PRL)、总睾酮(TT)及性激素结合球蛋白(SHBG);检测甲状腺功能,包括促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)、总甲状腺激素(TT4)、游离甲状腺激素(FT4)水平。分析基本体质指标、性激素水平及甲状腺功能指标与FSFI评分的相关性。结果共有234例PCOS女性纳入统计分析,FSFI总分平均值为(24.21±2.93),79.06%的患者被认为有性功能障碍高风险(cut-off值26.55)。斯皮尔曼相关性分析显示,年龄、BMI、腰围、腰臀比与FSFI得分呈负相关(P<0.05);总睾酮与性满意度得分呈负相关(r=-0.213,P=0.041),游离雄激素指数(FAI)与性高潮得分呈正相关(r=0.167,P=0.035);TSH与性欲及阴道润滑得分呈负相关(分别为r=-0.162,P=0.032;r=-0.185,P=0.017),FT4与FSFI总分呈正相关(r=0.223,P=0.031)。其余性激素和甲状腺激素及SHBG、PRL与FSFI得分之间未显示显著相关性(P>0.05)。结论 PCOS患者的性功能与雄激素水平及甲状腺功能有关,临床诊疗中对PCOS患者的高雄激素及甲状腺功能异常应予以重视和管理。
Abstract：Objective:To analyze the relationship of sexual function with sex hormones and thyroid hormones in women with polycystic ovary syndrome(PCOS).Methods:This cross-sectional study was performed on the women with PCOS,who referred to Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital from January 2019 to December 2019. The Chinese version of Female Sexual Function Index(FSFI) was used to evaluate the sexual functions. Their basic physical indexes and serum sex hormone levels including FSH,LH,prolactin(PRL),total testosterone(TT),sex hormone binding globulin(SHBG),and thyroid function including thyroid stimulating hormone(TSH),total triiodothyronine(TT3),free triiodothyronine(FT3),total thyroxine(TT4),and free thyroxine(FT4) were measured. The correlation between FSFI score and basic physical fitness index, sex hormone level and thyroid function index was analyzed.Results:A total of 234 PCOS women were included in the analyses. The mean total FSFI score was(24.21±2.93). According to FSFI definitions(cut-off score 26.55),79.06% of women were at risk of female sexual dysfunction(FSD). Spearman's correlations showed there were significant negative correlations between FSFI scores and age, body mass index(BMI),waist circumference(WC),waist-hip ratio(WHR)(P<0.05). Total testosterone was negatively correlated to satisfaction(r=-0.213,P=0.041), and free androgen index(FAI) positively related to increased orgasm score(r=0.167,P=0.035). TSH was negatively correlated with scores of sexual desire and vaginal lubrication(r=-0.162,P=0.032;r=-0.185,P=0.017,respectively). FT4 was significantly positively correlated with FSFI total score(r=0.223,P=0.031). There were no significant correlations between FSFI scores and other sex hormonal and thyroid hormones, SHBG and PRL(P>0.05).Conclusions:Sexual function in patients with PCOS is correlated with androgen level and thyroid functions. Clinicians should pay attention to and manage hyperandrogenism and thyroid dysfunction in women with PCOS.
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基本信息:
中图分类号:R711.75
引用信息:
[1]田玄玄,阮祥燕,杜娟,等.多囊卵巢综合征女性性功能与性激素和甲状腺激素的相关性[J].生殖医学杂志,2021,30(04):496-501.
基金信息:
北京市医院管理中心“登峰”计划专项经费(DFL20181401)
2021-04-15
2021-04-15