吡格列酮二甲双胍片对初诊多囊卵巢综合征患者性激素胰岛素抵抗及血清炎症指标的影响

Effect of Pioglitazone and Metformin Tablets on Sex Hormones Insulin Resistance,Serum Inflammatory Parameters in Patients with Primary Polycystic Ovary Syndrome

目的:探讨吡格列酮二甲双胍片对初诊多囊卵巢综合征患者性激素、胰岛素抵抗及超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:回顾性分析2018年1月至2020年10月收治的97例PCOS患者,根据患者治疗方案分为研究组47例和对照组50例。两组患者均给予炔雌醇环丙孕酮片,对照组给予二甲双胍片,研究组给予吡格列酮二甲双胍片,疗程3个月。比较两组疗效、性激素、胰岛素抵抗指数、血清hs-CRP、IL-6、TNF-α水平、生活质量。结果:研究组治疗总有效率为93.62%,高于对照组的78.00%(P<0.05)。治疗后,两组患者的促黄体生成激素、睾酮、空腹血糖、空腹胰岛素、胰岛素抵抗指数、血清hs-CRP、IL-6、TNF-α水平均明显下降(P<0.05),生活质量总分明显上升(P<0.05);并且研究组促黄体生成激素、睾酮、空腹血糖、空腹胰岛素、胰岛素抵抗指数、hs-CRP、IL-6、TNF-α、生活质量总分治疗前后的差值均大于对照组(P<0.05)。结论:相比单一药物治疗,吡格列酮二甲双胍片治疗初诊多囊卵巢综合征更具优势,显著降低促黄体生成激素、睾酮水平,改善胰岛素抵抗,调节炎症因子,提高生活质量。

Objective:To investigate the effect of pioglitazone and metformin tablets on sex hormones,insulin resistance,high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in patients with primary polycystic ovary syndrome(PCOS).Methods:A total of 97 patients with PCOS admitted to our hospital between January 2018 and October 2020 were analyzed retrospectively.According to the treatment regimens,the patients were divided into study group(47 cases)and control group(50 cases).All were treated with ethinylestradiol cyproterone tablets.On this basis,the control group was treated with metformin tablets,and the study group was treated with pioglitazone and metformin tablets,for 3 months.The curative effect,sex hormones,insulin resistance index,serum hs-CRP,IL-6 and TNF-αlevels,and quality of life were compared between the two groups.Results:The total effective rate of treatment in the study group was 93.62%,higher than 78.00%in the control group(P<0.05).After treatment,the levels of luteinizing hormone,testosterone,fasting blood glucose,fasting insulin,insulin resistance index,serum hs-CRP,IL-6 and TNF-αwere significantly reduced(P<0.05),and the total quality of life scores were significantly increased(P<0.05).Meanwhile,the difference before and after treatment of luteinizing hormone,testosterone,fasting blood glucose,fasting insulin,insulin resistance index,serum hs-CRP,IL-6,TNF-αand the total quality of life score in the study group were higher than those in the control group(P<0.05).Conclusion:Pioglitazone and metformin tablets are more advantageous than monotherapy in the treatment of primary polycystic ovary syndrome,significantly reducing luteinizing hormone and testosterone levels,improving insulin resistance,regulating inflammatory factors and improving quality of life.