炔雌醇环丙孕酮片联合二甲双胍治疗肥胖型PCOS有效性的随机对照研究  

Comparetive study on the efficacy of ethinylestradiol cyproterone tablets and metformin for treating patients with polycystic ovary syndrome

作　　者：刘钦文 綦萍 张海艳 王璇 LIU Qinwen;QI Ping;ZHANG Haiyan;WANG Xuan(Qingdao Jiaozhou Central Hospital,Jiaozhou,Shandong Province,266300)

机构地区：[1]青岛市胶州中心医院,266300

出　　处：《中国计划生育学杂志》2024年第7期1498-1502,共5页Chinese Journal of Family Planning

基　　金：青岛市医疗卫生重点学科建设项目资助。

摘　　要：目的:探究二甲双胍治疗肥胖型多囊卵巢综合征(PCOS)效果及对患者性激素、妊娠率及妊娠期并发症的影响。方法:采用随机对照研究方法,纳入2021年7月-2023年1月本院收治的PCOS患者210例,随机数字法分为对照组(n=102,炔雌醇环丙孕酮片治疗)和观察组(n=108,炔雌醇环丙孕酮片联合二甲双胍治疗)。比较两组治疗前后一般情况指标[体重、体质指数(BMI)、腰臀比(WHR)]、糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数HOMA-IR]、脂代谢指标[总胆固醇(TC)、载脂蛋白A(ApoA)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]、性激素指标[促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、雌二醇(E_(2))];随访9个月,统计妊娠率及统计妊娠期并发症。结果:治疗后,两组体重、BMI、WHR均下降且观察组(63.0±8.7 kg、26.1±2.9 kg/m^(2)、0.73±0.15)低于对照组(66.4±9.7 kg、27.6±3.5 kg/m^(2)、0.82±0.19),观察组FPG(4.01±0.96 mmol/L)、FINS(18.69±2.94 mU/L)、HOMA-IR(3.30±0.88)水平均低于对照组(4.96±1.10 mmol/L、22.37±3.82 mU/L、4.93±1.10),两组TC、HDL-C、LDL-C水平均下降且观察组低于对照组,两组ApoA水平均上升且观察组高于对照组,两组LH、T、E_(2)水平均下降,两组FSH水平均上升,且观察组指标水平变化幅度大于对照组(均P<0.05)。结论:二甲双胍治疗PCOS疗效提高,利于提升患者糖、脂代谢能力,改善患者内分泌功能,纠正代谢紊乱,从而提高妊娠率,且妊娠期并发症发生风险降低。Objective:To explore the effect of metformin for treating patients with polycystic ovary syndrome(PCOS),and to study its influence on the sex hormones levels,pregnancy rate and pregnancy complications of the patients.Methods:A randomized controlled trial was used in this study.From July 2021 to January 2023,210 patients with PCOS were selected and were divided into control group(102 patients treated with ethinylestradiol cyproterone tablets)and observation group(108 patients treated with metformin) according to random number method.The values of the general condition indexes,such as body weight,body mass index(BMI) and waist-to-hip ratio(WHR),the levels of glucose metabolism indexes,such as fasting plasma glucose(FPG),fasting insulin(FINS) and homeostasis model assessment of insulin resistance(HOMA-IR),the levels of lipid metabolism indexes,such as total cholesterol(TC),apolipoprotein A(apoA),high density lipoprotein(HDL-C) and low density lipoprotein(LDL-C),and the levels of sex hormone indexes,such as luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T) and estradiol(E_(2)) of the patients before and after treatment were compared between the two groups.The pregnancy rate and the complications situation of the patients during pregnancy were followed up for 9 months after treatment continually.Results:After treatment,the values of body weight,BMI and WHR of the patients in the two groups had decreased significantly,and which(63.0±8.7 kg,26.1±2.9 kg/m^(2) and 0.73±0.15) of the patients in the observation group were significantly lower than those(66.4±9.7 kg,27.6±3.5 kg/m^(2) and 0.82±0.19) of the patients in the control group.The levels of FPG(4.01±0.96 mmol/L),FINS(18.69±2.94 mU/L) and the HOMA-IR value(3.30±0.88) of the patients in the observation group were significantly lower than those(4.96±1.10 mmol/L,22.37±3.82mU/L and 4.93±1.10) of the patients in the control group.The levels of TC,HDL-C and LDL-C of the patients in the two groups had decreased significantly,and which of th

关 键 词：肥胖型多囊卵巢综合征 二甲双胍 体质指数 糖脂代谢 性激素 妊娠 妊娠期并发症 

分 类 号：R711.75[医药卫生—妇产科学]