罗格列酮对多囊卵巢综合征患者血清C-反应蛋白水平和排卵率的影响

Study of the effect of rosiglitazone on serum C-reactive protein level and ovulation in patients with polycystic ovary syndrome

目的观察多囊卵巢综合征(PCOS)患者血清C-反应蛋白(CRP)水平及罗格列酮(RGZ)对PCOS患者CRP和排卵的影响,探讨RGZ的作用机制。方法选择门诊确诊的PCOS患者108例及健康育龄妇女40例(对照组),监测体重指数(BMI)、超敏CRP、胰岛素敏感指数(ISI)及相关性激素。将PCOS患者随机分为3组,A组:36例,年龄(26.3±3.8)岁,单用克罗米芬(CC)促排卵治疗;B组:36例,年龄(26.5±3.7)岁,单用RGZ治疗;C组:36例,年龄(26.6±3.4)岁,RGZ联合CC治疗。治疗3个周期(12周)重复检测上述各指标,并计算各组排卵率。结果PCOS组ISI明显低于对照组,CRP水平明显高于对照组(P均<0.01);ISI<0.021者占59.3%,经相关性分析CRP与ISI等指标无相关性(P均>0.05)。PCOS患者治疗后B组和C组CRP水平明显下降,ISI明显升高(P均<0.01),而A组则无显著变化(P>0.05);治疗后A、B、C 3组的排卵率分别为58.3%、33.3%和83.3%。结论PCOS的发生除与胰岛素抵抗(IR)有关外,炎症反应也参与了其发病,而且独立于其他因素;RGZ具有抗IR、抗炎症、恢复PCOS患者排卵的作用。

Objective： To investigate the effect of rosiglitazone （RGZ） on serum C-reactive protein （CRP） level and ovulation in the patients with polycystic ovary syndrome （PCOS）. Methods. 108 patients with PCOS and 40 healthy women were recruited. Body mass index （BMI）, waist to hip ratio （WHR）, CRP, insulin sensitivity index （ISI） and related hormones were determined. The patients with PCOS were randomly divided into three groups： group A （treated with clomiphene）, B （with RGZ） and C （with the combination of RGZ and clomiphene）, with 36 patients in each group. 12 weeks later, the parameters were determined again, and the ovulation rate in each group was recorded. Results： Mean ISI was significantly lower in the patients with PCOS than that of healthy women （P〈0.01） while CRP levels were significantly higher （P〈0.01）. ISI of 59.3% PCOS patients was lower than 0. 021. Relativity analysis showed that there was no relationship between CRP and ISI （P〉0.05）. After the treatment, CRP level decreased and ISI increased significantly in the patients both in group B and C （P〈0.01）, but there was no much change in group A （P〉0.05）. The ovulation rates in three groups were 58.3%, 33.3% and 83.3% respectively. Conelusion： Both insulin resistance and inflammatory reaction are involved in the pathology of PCOS. The inflammatory reaction might be an independent contributor. RGZ improves both insulin resistance and ovulation in PCOS patients.