达英-35及二甲双胍对多囊卵巢综合征患者血清单核细胞趋化蛋白-1及血脂的影响机制研究

Study of the influence mechanism of Diane-35 and metformin treatment on blood cells list chemoattractant protein-1 and blood lipid of polycystic ovary syndrome patients

目的探讨达英-35及二甲双胍对多囊卵巢综合征(PCOS)患者血清单核细胞趋化蛋白-1(MCP-1)及血脂水平变化的影响及疗效。方法选择72例PCOS患者随机分为观察组(达英-35联合二甲双胍组)和对照组(达英-35组),各36例。观察并比较两组患者治疗前后MCP-1、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)水平的变化,并观察促排卵的疗效及不良反应。结果观察组患者血清MCP-1、TC、TG水平均较治疗前明显下降,HDL-C较治疗前明显升高,且观察组的临床表现如月经稀发、痤疮、多毛及卵巢体积增大、多囊性改变患者较治疗前明显减少,改善程度较对照组更明显(P<0.05)。观察组患者的妊娠率高,无一例发生卵巢过度刺激综合征(OHSS),明显优于对照组(P<0.05)。结论达英-35及二甲双胍对PCOS患者是一种安全、有效的治疗方法,其作用机制可能为MCP-1参与了PCOS的发生、发展过程,并通过降低血脂而影响PCOS的疗效,但其具体机制尚有待进一步深入研究。

Objective To explore the influence and effects of Diane-35 and Metformin on the changes of serum MCP-1 and lipid levels in polycystic ovary syndrome（PCOS） patients.Methods All 72 cases of PCOS patients were randomly divided into observation group（Diane-35 combined with Metformin） and control group（Diane-35）,each group had 36 cases resepectively.The level of MCP-1,TC,TG,HDL-C were observed and compared between the two groups before and after treatment,and the effect of ovulation induction and adverse reactions were observed.Results After treatment the MCP-1,TC,TG levels of observation group all decreased significantly compared with before treatment,and HDL-C level significantly increased than before treatment.The observation group patients with clinical manifestations such as oligomenorrhea,acne,hirsutism,ovarian volume increase and polycystic change significantly reduced,compared with before treatment,and the degree of improvement of the observation group was more obvious than the control group（P 0.05）.The pregnancy rate of the observation group was higher than that of the control group,and there was no case suffered with OHSS（P 0.05）.Conclusion Diane-35 combined with Metformin in the treatment of PCOS is a safe and effective method,and its mechanism may that MCP-1 participates in the development and progression of PCOS and by means of lowering cholesterol to affect the effect of PCOS,but the specific mechanism remains further study.