维生素D与炔雌醇环丙孕酮片对多囊卵巢综合征患者卵巢功能及糖脂代谢的影响  

Effects of vitamin D and ethinyl estradiol and cyproterone tablets on ovarian function and glucose and lipid metabolism in patients with polycystic ovary syndrome

作　　者：张霞[1] 李飞[2] 牛爱琴[1] Zhang Xia;Li Fei;Niu Aiqin(Department of Gynecology,Shangqiu First People’s Hospital,Shangqiu 476100,China;Department of Reproductive Center,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院妇科,商丘476100 [2]商丘市第一人民医院生殖中心,商丘476100

出　　处：《中华内分泌外科杂志（中英文）》2024年第6期806-811,共6页Chinese Journal of Endocrine Surgery

基　　金：河南省医学科技攻关计划项目(LHGJ20200933)。

摘　　要：目的探讨维生素D与炔雌醇环丙孕酮片联合治疗多囊卵巢综合征(PCOS)患者,对其卵巢功能及糖脂代谢的影响。方法选取2021年1月至2023年5月在商丘市第一人民医院治疗的PCOS患者147例作为研究对象,按照治疗方法的不同分组为对照组75例和观察组72例,对照组采取屈炔雌醇环丙孕酮片治疗,观察组在对照组的基础上补充维生素D。比较两组治疗前后的卵巢功能指标[平均卵巢直径(MOD)、窦状卵泡数(AFC)]、糖脂代谢指标变化[空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血清胰岛素(FINS)],及卵巢功能改善情况(月经稀少、排卵和妊娠情况)、临床治疗疗效和不良反应发生情况。结果治疗后,观察组FPG、FINS、TC、TG、LDL-C水平显著低于对照组,HDL-C水平显著高于对照组(P<0.05);治疗后,观察组MOD、AFC均显著高于对照组,卵巢体积显著低于对照组(P<0.05)。观察组月经稀少率为13.89%、排卵率为83.33%、妊娠率为62.50%,对照组分别为62.50%、64.00%、44.00%,观察组月经稀少显著低于对照组,排卵和妊娠改善情况均显著高于对照组(P<0.05);观察组总有效率为95.83.%,对照组为73.33%,观察组总效率高于对照组(P<0.05)。观察组治疗期间的不良反应发生率为6.94%,对照组为9.33%,两组不良反应发生情况对比差异无统计学意义(P>0.05)。结论采用维生素D与炔雌醇环丙孕酮片联合用药治疗PCOS,能更有效改善卵巢功能及糖脂代谢,提高排卵率及妊娠率,临床效果确切,且不良反应较少。ObjectiveTo investigate the effects of vitamin D and ethinyl estradiol and cyproterone tablets in the treatment of patients with polycystic ovary syndrome(PCOS)on ovarian function and glucose and lipid metabolism.Methods147 PCOS patients treated in our hospital from Jan.2021 to May.2023 were selected as the research objects.According to the different treatment methods,they were divided into a control group of 75 cases and an observation group of 72 cases.The control group were treated with dynylestradiol and cyproterone.Ketone tablets treatment,the observation group was supplemented with vitamin D on the basis of the control group.Fasting blood-glucose(FPG),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL cholesterol(LDL-C),fasting serum insulin(FINS)],as well as improvement in ovarian function(menstrual scarcity,ovulation and pregnancy),clinical efficacy of treatment,and occurrence of adverse effects.ResultsAfter treatment,FPG,FINS,TC,TG,and LDL-C levels in the observation group were significantly lower and HDL-C levels were significantly higher in the observation group than those in the control group(P<0.05).After treatment,MOD and AFC were significantly higher and ovarian volume was significantly lower in the observation group than those in the control group(P<0.05).The rate of scanty menstruation was 13.89%,the rate of ovulation was 83.33%,and the rate of pregnancy was 62.50%in the observation group,and 62.50%,64.00%,and 44.00%in the control group,respectively.Scanty menstruation in the observation group was significantly lower than that in the control group,and the improvement of ovulation and pregnancy was significantly higher than that in the control group(P<0.05).The total effective rate in the observation group was 95.83.%,and that in the control group was 73.33%,the total efficiency of the observation group was higher than that of the control group(P<0.05).The incidence of adverse reactions during the treatment period was 6.94%

关 键 词：维生素D 炔雌醇环丙孕酮片 多囊卵巢综合征 卵巢功能 糖脂代谢 

分 类 号：R711.75[医药卫生—妇产科学]