罗格列酮治疗42例超重/肥胖妇女月经紊乱的临床观察  

Clinical investigation about the effect of rosiglitazone on fourty-two overweight/obese women with menstrual disorders

作　　者：沈云峰[1] 余戎[1] 赖晓阳[1] 

机构地区：[1]南昌大学第二附属医院内分泌科,江西南昌330006

出　　处：《中国妇幼保健》2007年第13期1744-1745,共2页Maternal and Child Health Care of China

摘　　要：目的:观察罗格列酮对超重/肥胖妇女月经紊乱的治疗效果,并对其机制进行初步探讨。方法:42例已排外其他可引起月经紊乱的疾病且存在高胰岛素血症的超重/肥胖伴月经紊乱妇女,给予罗格列酮4～8mg/天治疗6个月。葡萄糖氧化酶法测定治疗前后空腹、餐后2h血浆血糖(FPG、PPG);放射免疫法测定空腹血清胰岛素(FINS)、黄体生成素(LH)、睾酮(T)、胰岛素样生长因子1(IGF-1);稳态模型(HOMA-IR)评估胰岛素敏感程度。结果:治疗后33例恢复正常月经,所有患者与治疗前相比,FPG水平无变化(5·1±0·5vs4·9±0·5,P>0·05),而PPG、FINS、LH、T、IGF-1水平明显下降(PPG:8·8±1·2vs7·6±0·9mmol/L,P<0·05;FINS:25·36±7·66vs14·97±5·18μIU/ml,P<0·05;LH:13·75±2·84vs10·38±2·26IU/L,P<0·05;T:3·37±1·09vs1·81±0·76nmol/L,P<0·01;IGF-1:98·43±11·72vs52·69±9·57ng/ml,P<0·01),HOMA-IR明显升高(5·93±1·02vs3·16±0·74,P<0·01)。结论:罗格列酮可通过改善超重/肥胖妇女的胰岛素抵抗状态,纠正性激素的异常反馈调节,从而恢复正常月经。Objective： To observe the therapatic effect of rosiglitazone on overweight/obese women with menstruation disorder, and to explore the potential mechanism. Methods： Fourty - two overweight/obese women with hyperinsulinemia and menstrual disorders but had no other diseases induced menstrual disorders were given rosiglitazone （4 ～ 8 mg/d） for six months. FPG, PPG with hexokinase method and FINS, FSH, LH, T and IGF - 1 were detected by radioimmunoassay to evaluate insulin sensitivity with homeostasis model assessment （ HOMA - IR） . Results： Thirty - three women recovered normal menstruation. The levels of FPG had no change （5. 1 ±0. 5 vs 4. 9 ±0. 5 mmol/L, P 〉0. 05）, but PPG, FINS, FSH, LH, T, IGF - 1 decreased significantly （PPG： 8. 8 ± 1. 2 vs 7. 6 ±0. 9 mmol/L, P 〈 0. 05; FINS： 25. 36±7. 66 vs 14. 97 ±5. 18 μIU/ml, P〈0.05; LH： 13. 75 ±2. 84 vs 10. 38 ±2. 26 IU/L, P〈0.05; T： 3.37 ± 1.09 vs 1.81 ± 0. 76 nmol/L, P 〈 0. 01 ; IGF - 1 ： 98. 43 ± 11. 72 vs 52. 69 ± 9. 57 ng/ml, P 〈 0. 01 ）, HOMA - IR elevated significantly （5. 93 ± 1. 02 vs 3. 16 ±0. 74, P 〈0. 01 ） . Conclusion： Rosiglitazone can restore the menstruation of women with overweight/obese by ameliorating their insulin resistance and retrieving abnormal feedback regulation of sexual hormone.

关 键 词：罗格列酮 超重/肥胖 月经紊乱 

分 类 号：R713[医药卫生—妇产科学]