不同干预措施对青春期肥胖型多囊卵巢综合征患者糖脂代谢的影响  

The effects of different interventions on the metabolism of glucose and lipid metabolism among obese adolescents with polycystic ovary syndrome

作　　者：陆杉[1] 倪运萍[1] 冯妙芙[1] 卢兴宏[1] 邓雪梅[1] 

机构地区：[1]广东省中医院生殖医学科,广东广州510006

出　　处：《中国预防医学杂志》2015年第3期205-208,共4页Chinese Preventive Medicine

基　　金：广东省科技计划项目(2011B061300075)

摘　　要：目的探讨不同干预措施对青春期肥胖型多囊卵巢综合征（polycystic ovary syndrome,PCOS）患者糖脂代谢的影响。方法采用三种干预措施对138例年龄13~20岁青春期肥胖女性进行单纯随机分组治疗3个月。治疗方案为,A组（46例）：炔雌醇环丙孕酮（达英-35）＋二甲双胍＋生活方式调整;B组（47例）：生活方式调整;C组（45例）：达英-35＋二甲双胍。比较3组治疗前后体质指数（BMI）、腰臀比（WHR）、空腹/餐后2h血糖、稳态模型-胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的变化。结果三种干预措施均可显著降低BMI,但生活方式调整联合药物治疗同时可以降低HOMA-IR,差异有统计学意义（P〈0.05）。三种干预措施治疗前后TC、HDL-C、LDL-C比较差异均无统计学意义。结论调整生活方式结合达英-35、二甲双胍治疗能够有效降低青春期肥胖型PCOS患者的BMI、改善胰岛素抵抗,短期治疗前后脂代谢变化不明显。Objective To discuss the effects of different interventions on the metabolism of glucose and lipid among obese adolescents with polycystic ovary syndrome（PCOS）. Methods 138 obese adolescents ages 13-20 years old were randomly divided into three groups and treated differently for 3months.Patients in group A were treated with Daine-35 and metformin,plus lifestyle modification.Patients in group B only underwent lifestyle adjustment and patients in group C were treated with Daine-35 and metformin.Changes of BMI,WHR,HOMA-IR,blood glucose,TC,TG,HDL-C,LDL-C of all subjects before and after the intervention were recorded and compared. Results BMI of all subjects decreased significantly after interventions,however,HOMA-IR also dropped dramatically among patients in groups A,the differences were significant（P〈0.05）.The differences of TC,HDL-C,LDL-C were not statistically significant before and after the intervention among adolescents in all three groups（P〉0.05）. Conclusions Drug treatment combined with lifestyle modification may lower the BMI of obese adolescents with PCOS and improve insulin resistance.However,shortterm treatment has no obvious effects on improving lipid metabolism.

关 键 词：青春期 肥胖 多囊卵巢综合征 治疗 稳态模型-胰岛素抵抗指数(HOMA-IR) 糖脂代谢 

分 类 号：R711.75[医药卫生—妇产科学]