减肥治疗对肥胖多囊卵巢综合征患者的效果观察  

Weight loss treatment for patients with polycystic ovary syndrome

作　　者：黄建霞[1] 张治芬[1] 

机构地区：[1]杭州市第一人民医院妇产科,310006

出　　处：《浙江医学》2013年第6期453-456,共4页Zhejiang Medical Journal

基　　金：浙江省科技计划项目(2009C33114);浙江省医药卫生科学研究基金(2008A107)

摘　　要：目的观察减肥治疗对肥胖型多囊卵巢综合征(PCOS)患者的疗效。方法选取2009年1月至2011年1月肥胖型PCOS患者50例,予减肥治疗3个月,观察体重、血压、BMI、痤疮、多毛等,关注月经变化和排卵情况6个月,检测患者治疗前后血清生殖内分泌激素及糖脂代谢指标。结果减肥3个月后,BMI平均下降2.18±199,43例痤疮患者,39例痤疮好转。50例患者均存在月经失调,26例恢复规律的排卵性月经。26例多毛患者,14例减轻(P<0.01)。LH、TT、FAI、性激素结合球蛋白(SHBG)、硫酸脱氢表雄酮(DHEAS)、胰岛素样生长因子1(IGF1)、胰岛素样生长因子结合蛋白3(IGFBP3)、FPG、FINS、HOMA-IR、TC、HDL、Apo B、LEP、ADPN等指标减肥后有所改善(均P<0.05)。PRL、E_2、TG、LDL、ApoA1、脂蛋白a、FSH治疗前后差异均无统计学意义(均P>0.05)。结论减肥可以改善PCOS患者的临床症状及血清生殖激素及糖脂代谢指标,是肥胖PCOS患者的有效治疗方法,值得临床应用。@@@@Objective To evaluate the effect of weight reduction in obese patients with polycystic ovary syndrome (PCOS). Methods Fifty obese patients with PCOS were recruited in the study from January 2009 to January 2011. The only treatment for patients was weight reduction for three months. The gonadal hormones, blood sugar, blood lipids, body weight, blood pressure, body mass index (BMI) and relevant clinical manifestations were assessed before and after three months of treatment. The men-strual changes and ovulation of patients were followed up for 6 months. Results After three months of weight loss treatment, the BMI was decreased by 2.18±1.99 kg/m2 on average. Among 43 patients who had acne, 39 improved;and of the 28 hairy pa-tients (F-G score 10.88 points), 14 were improved (F-G score 8.65 points). Al 50 patients with menstrual disorder (one had poly-menorrhea, one oligomenorrhea, others had amenorrhea) were fol owed up for 6 months, 26 of them had a restitution of regular cycles. After weight loss, LH, TT, FAI, SHBG, DHEAS, IGF1, IGFBP3, FBG, FINS, HOMA-IR, TC, HDL, APoB, LEP, ADPN im-proved significantly (P<0.05), while PRL, E2, TG, LDL, ApoA1, Lipoprotein A and FSH were not improved (P>0.05). Conclusion Weight loss is an effective treatment for overweight PCOS patients, which can improve the serum level of gonadal hormones, blood sugar, blood lipids and clinical manifestations of PCOS.

关 键 词：减肥 多囊卵巢综合征 瘦素 脂联素 胰岛素抵抗 高雄激素血症 

分 类 号：R711.75[医药卫生—妇产科学]