吡格列酮与二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征患者血清性激素水平及妊娠率的影响

Effect of pioglitazone and metformin combined with ethinyl estradiol and cyproterone tablets on serum sex hormone levels and pregnancy rate in patients with polycystic ovary syndrome

目的分析吡格列酮与二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征(PCOS)患者血清性激素水平及妊娠率的影响。方法选取2018年1月至2019年8月本院收治的86例PCOS患者,依据随机数字表法分为对照组和实验组,每组43例。对照组采用二甲双胍、炔雌醇环丙孕酮片联合治疗,实验组采用吡格列酮与二甲双胍联合炔雌醇环丙孕酮片治疗,比较两组临床疗效、随访6个月妊娠率以及治疗前后血清性激素[睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)]水平、氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平。结果实验组治疗总有效率为95.35%,高于对照组的79.07%(P<0.05);治疗后,实验组FSH、LH、T均低于对照组(P<0.05);治疗后,实验组SOD高于对照组,MDA低于对照组(P<0.05);随访6个月,实验组妊娠率为90.48%,高于对照组的71.43%,差异具有统计学意义(P<0.05)。结论吡格列酮与二甲双胍联合炔雌醇环丙孕酮片治疗PCOS效果显著,可有效改善患者血清性激素水平,缓解胰岛素抵抗,减轻氧化应激反应,提高妊娠率。

Objective To analyze the effects of pioglitazone and metformin combined with ethinyl estradiol and cyproterone tablets on serum sex hormone levels and pregnancy rate in patients with polycystic ovary syndrome(PCOS).Methods A total of 86 PCOS patients admitted to our hospital from January 2018 to August 2019 were selected and they were divided into control group and experimental group according to the random number table method,with 43 cases in each group.The control group received combined treatment with metformin and ethinyl estradiol and cyproterone tablets,and the experimental group received pioglitazone and metformin combined with ethinyl estradiol and cyproterone tablets.The clinical efficacy,6-month follow-up pregnancy rate and serum,sex hormones[testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH)]levels,oxidative stress response indicators[malonaldehyde(MDA),superoxide dismutase(SOD)]levels before and after treatment were compared between the two groups.Results The total effective rate of treatment in the experimental group was 95.35%,which was higher than 79.07%in the control group(P<0.05);after treatment,the FSH,LH and T of the experimental group were lower than those in the control group(P<0.05);after treatment,SOD in the experimental group was higher than that in the control group,MDA was lower than that in the control group(P<0.05);follow-up for 6 months,the pregnancy rate in the experimental group was 90.48%,which was higher than 71.43%in the control group,the difference was statistically significant(P<0.05).Conclusion Pioglitazone and metformin combined with ethinyl estradiol and cyproterone tablets are effective in the treatment of PCOS,which can effectively improve serum sex hormone levels,relieve insulin resistance,reduce oxidative stress,and increase pregnancy rate.