炔雌醇环丙孕酮联合不同药物治疗PCOS对患者免疫因子和氧化应激因子的影响

Effects of ethinylestradiol cyproterone combined with different drugs in treatment of PCOS on the immune factors and oxidative stress factors of patients

目的研究炔雌醇环丙孕酮联合不同药物治疗多囊卵巢综合征(PCOS)及对患者免疫因子、氧化应激因子的影响。方法 PCOS患者108例依照随机数字表法分为试验组和对照组,每组54例。对照组给予炔雌醇环丙孕酮+二甲双胍治疗,试验组给予炔雌醇环丙孕酮+二甲双胍+枸橼酸氯米芬治疗。观察治疗前后2组血清糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2hPG)等血糖指标,胰岛素抵抗指数(HOMA-IR),CD3^+、CD4^+、CD8^+、CD4^+/CD8^+等T细胞亚群,晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、超氧化物歧化酶(SOD)及谷胱甘肽过氧化物酶(GSH-PX)等应激因子,睾酮(T)、卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)等性激素水平。结果治疗后,2组HbA1c、FBG、2hPG水平及HOMA-IR差异无统计学意义(P>0.05)。试验组CD3^+、CD4^+、CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组(P<0.05)。试验组AOPP、MDA水平低于对照组(P<0.05),SOD、GSH-PX水平高于对照组(P<0.05)。试验组T、FSH、LH水平低于对照组(P<0.05),E2水平高于对照组(P<0.05)。结论炔雌醇环丙孕酮联合二甲双胍、枸橼酸氯米芬可有效抑制PCOS患者胰岛素抵抗,缓解氧化应激,纠正免疫失衡,促进机体激素正常分泌,改善机体激素水平。

Objective To investigate the effects of ethinylestradiol cyproterone combined with different drugs in treatment of polycystic ovary syndrome(PCOS) on the immune factors and oxidative stress factors of patients with PCOS.Methods A total of 108 patients with PCOS who were treated in our hospital from January 2015 to December 2018 were divided into experimental group(n=54) and control group(n=54) according to the random number table method.The patients in control group were treated by ethinylestradiol cyproterone +metformin,however,the patients in experimental group were treated by ethinylestradiol cyproterone+metformin+citrate clomiphene.The levels of blood glucose indexes including serum glycosylated hemoglobin(HbA1 c),fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),insulin resistance index(HOMA-IR),T cell subsets such as CD+3,CD+4,CD+4/CD+8 were detected before and after treatment.Moreover the changes of advanced oxidation protein products(AOPP),malondialdehyde(MDA),superoxide dismutase(SOD) and glutathione peroxidase(GSH-PX),and sex hormone levels including testosterone(T),follicle stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH) were observed and compared between the two groups.Results After treatment,there were no significant differences in the levels of HbA1 c,FBG,2 hPG and HOMA-IR between the two groups(P>0.05).The levels of CD+3,CD+4,CD+4/CD+8 in experimental group were significantly higher than those in control group,however, the CD+8 levels were significantly lower than those in control group(P<0.05).The levels of AOPP and MDA in experimental group were significantly lower than those in control group,but the levels of SOD and GSH-PX were significantly higher than those in the control group(P>0.05).Moreover the levels of T,FSH and LH in experimental group were significantly lower than those in control group,however, the E2 levels were significantly higher than those in control group(P>0.05).Conclusion The ethinylestradiol cyproterone combined with metformin and clomiphene citrate can effectively inhibit insulin resistance,relieve oxidative stress,correct immune imbalance,promote normal secretion of body hormones and improve hormone levels in patients with PCOS.