非痰湿型多囊卵巢综合征患者高血脂症的影响因素  

Influencing factors of hyperlipidemia in patients with non-phlegm-damp type polycystic ovary syndrome

作　　者：罗蓉 王宇[1,2] 高敬书[2] 丛晶[2] 葛航 刘洋[1] 张蓓[4] 吴效科[2,3] LUO Rong;WANG Yu;GAO Jingshu;CONG Jing;GE Hang;LIU Yang;ZHANG Bei;WU Xiaoke(Heilongjiang University of Chinese Medicine,Harbin 150040,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang Provincial Hospital,Harbin 150030,China;*Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]黑龙江中医药大学附属第一医院,哈尔滨150040 [3]黑龙江省医院,哈尔滨150030 [4]徐州市中心医院,徐州221000

出　　处：《中华中医药杂志》2024年第7期3833-3837,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：黑龙江省“头雁”团队项目(No.[2019]5号);国家重点研发计划中医药现代化研究重点专项(No.2019YFC1709500);国家重大疑难疾病中西医临床协作试点项目(No.国中医药办医政发[2018]3号);徐州市引进临床医学专家团队(No.2019TD005);黑龙江省中医药学会2022—2024年度青年人才托举工程项目(No.2022-QNRC1-02);黑龙江省中医药科研课题项目(No.ZHY2022-124)。

摘　　要：目的:探讨非痰湿型多囊卵巢综合征(PCOS)患者的人群特征以及高血脂症的影响因素。方法:选取479例“针刺联合克罗米芬对PCOS不孕妇女活产的影响”临床试验(PCOSAct)非痰湿型受试者为研究对象,分析该类患者的人群特征。再将患者分为血脂正常307例和高血脂症172例,分析两组的人口学特征及生化指标。最后分析各指标与血脂成分的相关性及高血脂症的危险或保护性因素。结果:血脂成分以低高密度脂蛋白胆固醇(HDL-c)型为主,20.46%(98/479)患者1种成分异常,14.82%(71/479)患者伴2~3种成分异常。高血脂症年龄、身体质量指数(BMI)、腰围、腰臀比、收缩压、游离雄激素、游离雄激素指数、空腹胰岛素、稳态模型胰岛素抵抗指数、总胆固醇、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-c)、载脂蛋白B、乳酸脱氢酶(LDH)、谷丙转氨酶、谷草转氨酶显著高于血脂正常(P<0.01,P<0.05);而黄体生成素(LH)、LH/卵泡刺激素、性激素结合球蛋白(SHBG)、HDL-c、载脂蛋白A1、总胆红素、直接胆红素(DB)显著低于血脂正常(P<0.01,P<0.05)。TG与肥胖、胰岛素抵抗及肝功能的相关性最强(P<0.01),HDL-c与性激素(尤其SHBG)及LDH的相关性最强(P<0.01)。年龄、BMI、LDH是高血脂症的危险性因素,而SHBG、DB是保护性因素。结论:非痰湿型PCOS患者仍伴有较严重的高血脂症,年龄、BMI、LDH是高血脂症独立的危险性因素,SHBG和DB是保护性因素。Objective:To explore the population characteristics of patients with non-phlegm-damp type polycystic ovary syndrome(PCOS)and influencing factors of hyperlipidemia.Methods:A total of 479 patients with non-phlegm-damp type in the clinical trial of the effect of acupuncture combined with Clomiphene on the live birth of infertile women with PCOS'(PCOSACt)were selected as the study objects,and the population characteristics were analyzed.The patients were then divided into 307 patients in the normal group and 172 patients in the hyperlipidemia group,and the demographic characteristics and biochemical differences between the two groups were analyzed.Finally,the correlation between each index and blood lipid composition and the risk or protective factors of hyperlipidemia were analyzed.Results:The dyslipidemic components were mainly low highdensity lipoprotein-cholesterol(HDL-C).20.46%(98/479)of patients had only one component abnormal,and 14.82%(71/479)had 2-3 types.Age,body mass index(BMI),waist circumference,waist-hip ratio,systolic blood pressure,free androgen,free androgen index,fasting insulin,homeostasis model assessment-insulin resistance index,total cholesterol,triglyceride(TG),low density lipoprotein-cholesterol,apolipoprotein B,lactate dehydrogenase(LDH),alanine aminotransferase,glutamic oxaloacetic transaminase in hyperlipidemia group were significantly higher than that of normal group(P<0.01,P<0.05);luteinizing hormone(LH),LH/follicle stimulating hormone,sex hormone-bound globulin(SHBG),HDL-c,apolipoprotein A1,total bilirubin and direct bilirubin(DB)in hyperlipidemia group were significantly lower than those in the normal group(P<0.01,P<0.05).TG had the strongest correlation with obesity,insulin resistance and liver function(P<0.01),and HDL-c had the strongest correlation with sex hormone(especially SHBG)and LDH(P<0.01).Age,BMI,and LDH were the independent risk factors for hyperlipidemia in these patients,and SHBG and DB were independent protective factors.Conclusion:Non-phlegm-damp type PCOS patients still

关 键 词：多囊卵巢综合征 非痰湿型 高血脂症 影响因素 生化指标 

分 类 号：R711.75[医药卫生—妇产科学] R589.2[医药卫生—临床医学]