奥利司他联合枸橼酸氯米芬对肥胖型多囊卵巢综合征患者子宫内膜厚度及血清性激素水平的影响  

Effect of orlistat combined with clomiphene citrate on endometrial thickness and serum sex hormone levels in patients with obese polycystic ovary syndrome

作　　者：马晓明 马煜磊[1] 闫谨 Ma Xiao-ming;Ma Yu-lei;Yan Jin(Department of Gynecology,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属医院妇科,河南南阳473000

出　　处：《四川生理科学杂志》2025年第2期250-252,398,共4页

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20211086)。

摘　　要：目的:探讨奥利司他联合枸橼酸氯米芬(Clomiphene citrate,CC)对肥胖型多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)患者子宫内膜厚度及血清性激素水平的影响。方法:回顾性分析2022年2月至2024年2月于我院诊疗的102例肥胖型PCOS患者资料,其中对照组(n=52)口服CC 50 mg·d^(-1),5 d·周期^(-1),观察组(n=50)基于对照组加用奥利司他口服60mg·次^(-1),3次·d^(-1)。比较两组临床疗效,于治疗前、治疗3 m后采用阴道超声仪检测子宫内膜厚度及卵巢体积,于治疗前、治疗3 m后采用化学发光免疫分析法检测血清雌二醇(Estradiol,E2)、黄体生成素(Luteinizing hormone,LH)、卵泡刺激素(Follicle-stimulating hormone,FSH)、睾酮(Testosterone,T)水平,采用酶联免疫吸附法检测抗苗勒氏管激素(Anti-mullerian hormone,AMH)、抑制素B(Inhibin B,IHNB)、血管紧张素Ⅱ(Angiotensin-Ⅱ,AT-Ⅱ)、血管内皮生长因子(Vascular endothelial growth factor,VEGF),并分析治疗期间不良反应总发生率。结果:观察组临床总有效率高于对照组(P<0.05);两组不良反应总发生率比较无明显差异(P>0.05);治疗3 m后两组子宫内膜厚度、卵巢体积小于对照组(P<0.05);治疗3 m后两组LH、E2、T、AT-Ⅱ、IHNB、VEGF、AMH均下降,FSH上升,其中观察组改善幅度更为显著(P<0.05)。结论:肥胖型PCOS患者经奥利司他联合CC治疗效果显著,可有效降低子宫内膜厚度,改善性激素水平,促进卵巢功能恢复,且具有一定安全性。Objective:To investigate the effect of orlistat combined with clomiphene citrate(CC)on endometrial thickness and serum sex hormone levels in patients with obese polycystic ovarian syndrome(PCOS).Methods:Aretrospective analysis was conducted on the data of 102 obese PCOS patients treated in our hospital from February 2022 to February 2024.The control group(n=52)received oral CC 50 mg·day^(-1),5 days·cycle^(-1),while the observation group(n=50)received an additional oral administration of orlistat 60 mg·time^(-1),3 times·d^(-1) based on the control group.The clinical efficacy of the two groups was compared.Before and after 3 months of treatment,the endometrium's thickness and the ovary's volume were measured using a transvaginal ultrasound.Before and after 3 months of treatment,the levels of serum estradiol(E2),luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T)were measured using a chemiluminescent immunoassay.The levels of anti-mullerian hormone(AMH),inhibin B(IHNB),angiotensin-II(AT-II),and vascular endothelial growth factor(VEGF)were measured using an enzyme-linked immunosorbent assay.The total incidence of adverse reactions was analyzed.Results:The total clinical effective rate in the observation group was higher than that in the control group(P<0.05).No significant differences were in the total incidence of adverse reactions between the two groups(P>0.05).After 3 months of treatment,the endometrial thickness and ovarian volume in both groups were smaller than the control group(P<0.05).After 3 months of treatment,LH,E2,T,AT-II,IHNB,VEGF,and AMH in both groups were decreased,while FSH was increased.The improvement in the observation group was more significant(P<0.05).Conclusion:The treatment of obese PCOS patients with orlistat combined with CC has important effects,which can effectively reduce endometrial thickness,improve sex hormone levels,promote ovarian function recovery,and have certain safety.

关 键 词：奥利司他 枸橼酸氯米芬 肥胖型多囊卵巢综合征 性激素 

分 类 号：R71[医药卫生—妇产科学]