艾塞那肽对多囊卵巢综合征胰岛素抵抗患者脂代谢及可溶性细胞间黏附分子-1的影响

Effect of exenatide on lipid metabolism and soluble intercellular adhesion molecule-1 in polycystic ovary syndrome patients with insulin resistance

目的观察艾塞那肽在多囊卵巢综合征(PCOS)胰岛素抵抗患者中的临床治疗效果及对脂代谢及可溶性细胞间黏附分子-1(s ICAM-1)的影响。方法选取2014年3月-2016年1月该院诊治的PCOS胰岛素抵抗患者60例,根据治疗方案不同分为观察组和对照组各30例。观察组采用艾塞那肽治疗,对照组采用二甲双胍治疗,比较两组治疗前后炎症因子、脂代谢及s ICAM-1水平。结果观察组治疗后白细胞、中性粒细胞、淋巴细胞、单核细胞和嗜酸性粒细胞水平显著高于对照组,差异有统计学意义(t=61.558、69.802、25.107、39.975、10.130,P<0.05);观察组治疗后甘油三酯(TG)、高密度脂蛋白(HDL)水平显著高于对照组(t=15.089,9.528,P<0.05),低密度脂蛋白(LDL)及总胆固醇(TC)水平显著低于对照组,差异有统计学意义(t=17.411、8.965,P<0.05);观察组治疗后空腹血糖(FPG)、空腹血清胰岛素(FINS)、胰岛素抵抗指数(HomaIR)及s ICAM-1水平显著低于对照组(t=15.389、9.467、21.514、135.783,P<0.05)。结论 PCOS胰岛素抵抗患者采用艾塞那肽治疗效果理想,能减轻患者亚临床炎症和胰岛素抵抗,改善患者脂代谢及s ICAM-1水平,值得推广应用。

Objective To observe the clinical therapeutic effect of exenatide in treatment of polycystic ovary syndrome（PCOS） patients with insulin resistance and its effect on lipid metabolism and soluble intercellular adhesion molecule-1（s ICAM-1）.Methods Sixty PCOS patients with insulin resistance were selected from the hospital from March 2014 to January 2016,then they were divided into control group（30 patients） and observation group（30 patients） according to therapeutic schedule.The paients in control group were treated with metformin,and the paients in observation group were treated with exenatide.The inflammatory cytokines,lipid metabolism and s ICAM-1levels before and after treatment in the two groups were compared.Results After treatment,the levels of leukocytes,neutrophils,lymphocytes,monocytes,and eosinophils in observation group were statistically significantly higher than those in control group（t = 61.558,69.802,25.107,39.975,10.130,P〈0.05）;the levels of triglyceride（TG） and high-density lipoprotein（HDL） in observation group were statistically significantly higher than those in control group（t = 15.089,9.528,P〈0.05）;the levels of low-density lipoprotein（LDL）and total cholesterol（TC） in observation group were statistically significantly lower than those in control group（t = 17.411,8.965,P 0.05）;fasting plasma glucose（FPG）,serum fasting insulin（FINS）,insulin resistance index（HOMA-IR）,and s ICAM-1 levels in observation group were statistically significantly lower than those in control group（t = 15.389,9.467,21.514,135.783,P〈0.05）.Conclusion The curative effect of exenatide in treatment of PCOS patients with insulin resistance is ideal,this drug can relieve subclinical inflammation and insulin resistance,improve lipid metabolism and s ICAM-1 level,which is worthy of promotion and application.