炔雌醇环丙孕酮片联合二甲双胍对多囊卵巢综合征患者血清DHEA、AMH及SHBG水平的影响  

Effects of ethinylestradiol and cyproterone acetate tablets combined with metformin on serum DHEA,AMH and SHBG in patients with polycystic ovary syndrome

作　　者：刘文娟 孙小红 刘晓娟[1] 毛世华[1] 万美英 Wen-juan Liu;Xiao-hong Sun;Xiao-juan Liu;Shi-hua Mao;Mei-ying Wan(Department of Gynecology and Obstetrics,Chongqing Three Gorges Central Hospital,Chongqing 404000,China;Department of Gynecology and Obstetrics,Wanzhou Hospital of Traditional Chinese Medicine,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院妇产科,重庆404000 [2]重庆市万州区中医院妇产科,重庆404000

出　　处：《中国现代医学杂志》2020年第12期109-113,共5页China Journal of Modern Medicine

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清硫酸脱氢表雄酮(DHEA)、抗缪勒管激素(AMH)、性激素结合球蛋白(SHBG)水平及经炔雌醇环丙孕酮片联合二甲双胍治疗后的变化。方法选取2018年12月—2019年10月在重庆三峡中心医院妇产科就诊的PCOS患者52例作为观察组。另取同期有规律月经周期、卵巢功能正常的育龄期女性55例作为对照组。观察组应用炔雌醇环丙孕酮片联合二甲双胍治疗,疗程3个月。比较两组治疗前血清DHEA、AMH及SHBG水平和观察组治疗前后血清DHEA、AMH及SHBG水平。采用Pearson法分析血清DHEA、AMH、SHBG与PCOS病情严重程度的关系。结果观察组治疗前DHEA、AMH较对照组高(P<0.05),SHBG较对照组低(P<0.05)。1型组治疗前血清DHEA、AMH水平高于3型组、4型组(P<0.05),SHBG水平低于3型组、4型组(P<0.05),2型组患者治疗前血清DHEA、AMH水平高于4型组(P<0.05),SHBG水平低于4型组(P<0.05)。血清DHEA、AMH与PCOS病情严重程度呈正相关(r=0.827和0.764,P<0.05),SHBG与PCOS病情严重程度呈负相关(r=-0.852,P<0.05)。观察组治疗后血清DHEA、AMH较治疗前低(P<0.05),SHBG较治疗前高(P<0.05)。结论PCOS患者血清DHEA、AMH水平升高,SHBG水平降低。血清DHEA、AMH及SHBG均能有效反映PCOS患者的病情严重程度。炔雌醇环丙孕酮片联合二甲双胍对PCOS患者具有良好的疗效,能有效改善患者血清DHEA、AMH及SHBG水平。Objective To investigate the levels of serum Dehydroepiandrosterone sulfate(DHEA),anti-Müllerian hormone(AMH)and sex hormone-binding globulin(SHBG)in patients with polycystic ovary syndrome(PCOS)and their changes after the treatment of ethinylestradiol and cyproterone acetate tablets(Diane-35)combined with metformin.Methods Fifty two PCOS patients were rolled in the gynecology department of our hospital from December 2018 to October 2019,and selected as the observation group.55 women of reproductive age with regular menstrual cycle and normal ovarian function were selected as the control group at the same time.The observation group was treated with Diane-35 and metformin for 3 months.The levels of serum DHEA,AMH and SHBG in the control group and in the observation group before and after treatment were detected and compared.Pearson correlation was used to analyze the relationship between serum DHEA,AMH,SHBG and the severity of PCOS.Results The levels of serum DHEA and AMH in the observation group were higher than those in the control group,while the level of SHBG was lower than that in the control group(P<0.05).Before treatment,the levels of serum DHEA and AMH in patients with type 1 were higher than those in patients with type 3 and type 4(P<0.05),while SHBG level was lower than that in patients with type 3 and type 4(P<0.05).The levels of serum DHEA and AMH in patients with type 2 were higher than that in patients with type 4(P<0.05),and SHBG level was lower than that in patients with type 4(P<0.05).Pearson correlation analysis showed that there was a positive correlation between serum DHEA(r=0.827),AMH(r=0.764)and severity of PCOS(P<0.05),and a negative correlation between serum SHBG(r=-0.852)and severity of PCOS(P<0.05).After treatment,the levels of serum DHEA and AMH in the observation group were lower than those before treatment(P<0.05),and the level of serum SHBG was higher than that before treatment(P<0.05).Conclusions The levels of serum DHEA and AMH increase while the serum SHBG level decrease in PCOS p

关 键 词：多囊卵巢综合征 硫酸脱氢表雄酮 二甲双胍 

分 类 号：R588.6[医药卫生—内分泌]