吡格列酮通过改善局部炎症协同克罗米酚治疗多囊卵巢综合征

Treatment of polycystic ovary syndrome with clomiphene combined with pioglitazone via improving local inflammation

目的:观察吡格列酮与克罗米酚联用对多囊卵巢综合征(PCOS)的临床疗效,并初步探究机制。方法:选取80例PCOS患者,分别给吡格列酮与克罗米酚联合治疗或单纯克罗米酚治疗,监测比较两组临床疗效、血清中激素及炎症因子水平。结果:联合组HCG注射日子宫内膜厚度大于对照组,妊娠率明显提高;相应血清黄体生成素/卵泡刺激素(LH/FSH)的比值、游离睾酮(FT)水平降低;而相应炎症因子C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)也显著下降。结论:吡格列酮联合克罗米酚应用可明显改善PCOS患者性激素水平紊乱,提高妊娠率及其临床治疗效果,这与吡格列酮下调CRP、TNF-α及IL-6等炎症因子、改善局部炎症反应密切相关。

Objective： To observe the clinical efficacy of clomiphene combined with pioglitazone in treatment of polycystic ovary syn- drome （PCOS）, preliminarily explore the mechanism. Methods： Eighty patients with PCOS were divided into combined treatment group （trea- ted with clomiphene combined with pioglitazone） and control group （treated with clomiphene ） ; the clinical efficacies, serum hormones and in- flammatory factors levels in the two groups were compared. Results： The thickness of endometrium on the day of HCG injection in combined treatment group was thicker than that in control group, the pregnancy rate in combined treatment group was higher than that in control group ; the ratio of luteinizing hormone （LH） /follicle.- stimulating hormone （FSH） and the levels of free testosterone, C -reactive protein （CRP）, tumor necrosis factor-α （TNF- α）, inter!eukin-6 （IL-6） in combined treatment group were lower than those in control group. Conclu- sion： Pioglitazone combined with clomiPhene can significantly improve sex hormones disorder of patients with PCOS, raise pregnancy rate and clinical curative effect, which are closely correlated with downregulation of CRP, TNF - α and IL - 6 induced by pioglitazone and improvement i of local inflammatory response.