吡格列酮联合炔雌醇环丙孕酮治疗肥胖型多囊卵巢综合征的效果及对患者血清中RBP-4因子水平的影响-现代医学

吡格列酮联合炔雌醇环丙孕酮治疗肥胖型多囊卵巢综合征的效果及对患者血清中RBP-4因子水平的影响

单位：1. 海口市第三人民医院检验科, 海南海口 570100;
2. 海口市第三人民医院妇产科, 海南海口 570100

分类号：R711.75

出版年·卷·期（页码）：2020·39·第三期（321-325）

摘要：

目的：探讨吡格列酮联合炔雌醇环丙孕酮用于肥胖型多囊卵巢综合征（PCOS）治疗的临床效果。方法：选取2013年1月至2017年12月本院收治的98例肥胖型PCOS患者，按随机数字表法分为对照组（n=49，炔雌醇环丙孕酮治疗）和观察组（n=49，吡格列酮加炔雌醇环丙孕酮治疗），观察患者性激素、血清视黄醇结合蛋白4（RBP-4）等改善情况。结果：治疗后，观察组患者血清黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）及RBP-4水平均显著低于对照组，雌二醇（E2）水平高于对照组（P<0.05）。观察组治疗后体质量指数（BMI）、空腹血糖（FPG）及甘油三脂（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平均显著低于对照组（P<0.05）；高密度脂蛋白胆固醇（HDL-C）水平显著高于对照组（P<0.05）。观察组治疗后不良反应总发生率为6.12%，显著低于对照组的20.41%（P<0.05）；排卵率、受孕率分别为85.71%、34.69%，显著高于对照组的61.22%、20.41%（P<0.05）。结论：给予肥胖型PCOS患者吡格列酮联合炔雌醇环丙孕酮治疗，可有效降低患者血清性激素、RBP-4水平，改善其代谢状态，总体疗效更理想。

Objective: To evaluate the clinical efficacy of pioglitazone and estriol combined with progesterone in the treatment of obese patients with polycystic ovary syndrome (PCOS). Methods: From January 2013 to December 2017, 98 patients with obesity PCOS were randomly divided into control group (n=49, estriol propropyl progesterone treatment)and observation group(n=49, estriol propionic progesterone+pioglitazone treatment),improvement of sex hormone and serum retinol binding protein 4 (RBP-4) were observed.Results: After treatment, the levels of luteinizing hormone (LH),follicle stimulating hormone (FSH), testosterone (T) and RBP-4 in the observation group were significantly lower than those in the control group, and Estradiol (E2) was higher than that in the control group(P<0.05);After treatment, the levels of Body mass index (BMI),fasting blood glucose (FPG), triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C)in the observation group were significantly lower than those in the control group(P<0.05), and the level of high density lipoprotein cholesterol (HDL-C) was significantly higher than that in the control group(P<0.05); The total incidence of adverse reactions in the observation group was 6.12%, which was significantly lower than that of the control group (20.41%,P<0.05). The ovulation rate and pregnancy rate were 85.71% and 34.69%, respectively, which were significantly higher than those of the control group, 61.22% and 20.41%(P<0.05). Conclusion: Estriol and progesterone combined with pioglitazone can effectively reduce the level of sex hormones and RBP-4 in obese PCOS patients, improve the metabolic state, whose overall curative effect is ideal.

参考文献：

[1] 张晓晨,崔璨.多囊卵巢综合征患者GLP-1、Ghrelin、Obestatin的变化[J].东南大学学报(医学版),2016,35(2):275-278.
[2] 宋艳丽,孙自学,卫爱武.二甲双胍对多囊卵巢综合征大鼠血清中网膜素-1水平的影响[J].东南大学学报(医学版),2019,38(1):23-27.
[3] 邓小艳,胡雅君,周海燕,等.达因-35对不同类型多囊卵巢综合征的疗效分析[J].生殖与避孕,2015,35(2):86-90.
[4] FU H,QIU Y,WEI F,et al.Spleen-Yang-deficiency patients with polycystic ovary syndrome have higher levels of visfatin[J].J Tradit Chin Med,2014,34(1):42-47.
[5] 徐文迪,陶弢,刘伟.多囊卵巢综合征代谢异常治疗新进展[J].上海交通大学学报(医学版),2015,35(9):1407-1413.
[6] 韦娟冰.来曲唑用于多囊卵巢综合征患者促排卵的临床疗效及安全性评价[J].中国临床药理学杂志,2015,31(19):1928-1930.
[7] 李荔,莫蕙,文斌,等.针灸联合二甲双胍治疗肥胖型多囊卵巢综合征不孕症的临床研究[J].中华中医药杂志,2014,29(7):2115-2119.
[8] QIU L,LIU J,HEI Q.Association between two polymorphisms of follicle stimulating hormone receptor gene and susceptibility to polycystic ovary syndrome:a meta-analysis[J].Chin Med Sci J,2015,30(1):44-50.
[9] 张添松,邹先翔,苏淑军,等.内脏脂肪素和二甲双胍对多囊卵巢综合征大鼠胰岛素抵抗和生殖内分泌的治疗作用[J].南方医科大学学报,2014,34(9):1314-1318.
[10] 邹晖.二甲双胍联合炔雌醇环丙孕酮治疗多囊卵巢综合征不孕症的效果[J].广东医学,2014,35(16):2614-2616.
[11] YU J,YU C,CAO Q,et al.Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome(draft)[J].J Integr Med,2017,15(2):102-109.
[12] 林微,李书艳,冯卫群.二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征的疗效及对相关激素分泌水平的影响[J].广东医学,2014,35(5):763-764.
[13] 孔冬冬,邸莎,马淑然,等.中医药治疗多囊卵巢综合征方剂用药规律分析[J].中国实验方剂学杂志,2015,21(23):202-206.
[14] 陈雅,叶碧绿,郑九嘉,等.血清及卵泡液抗苗勒管激素在多囊卵巢综合征患者体外受精促排卵治疗中的价值[J].中国临床药理学与治疗学,2015,20(12):1405-1411.
[15] 徐芳,侯丽辉,郝松莉,等.多囊卵巢综合征代谢组学研究进展[J].中国实用妇科与产科杂志,2016,32(5):489-494.
[16] 王情,冯艳婕,张仙儒,等.血清总睾酮/双氢睾酮值对多囊卵巢综合征合并肥胖的临床诊断意义[J].现代医学,2016,44(12):1726-1729.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录