吡格列酮联合二甲双胍治疗激素抵抗性PCOS不孕对患者性激素、炎症因子水平的影响

Effects of Pioglitazone and Metformin on the Levels of Sex Hormones and Inflammatory Factors in the Treatment of Hormone Resistant PCOS Infertility

【目的】探讨吡格列酮联合二甲双胍治疗激素抵抗性多囊卵巢综合征(PCOS)不孕对患者性激素、炎症因子水平的影响。【方法】选取120例激素抵抗性PCOS不孕患者,按随机数字表法分成观察组与对照组,每组60例。对照组采用二甲双胍治疗,观察组在对照组基础上加用吡格列酮治疗,比较两组临床疗效、治疗期间不良反应及治疗前后胰岛素抵抗(IR)指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、性激素[促卵泡生成素(FSH)、促黄体生成素(LH)、睾酮(T)、雌二醇(E2)]及炎症因子[白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)]水平。【结果】观察组患者总有效率为95.00%,明显高于对照组的80.00%,其差异有统计学意义(P<0.05)。与本组治疗前比较,两组治疗后FPG、FINS、HOMA-IR、FSH、LH、T、E2、IL-6、IL-17、TNF-α、hs-CRP均明显降低(P<0.05);治疗后,观察组FPG、FINS、HOMA-IR、FSH、LH、T、E2、IL-6、IL-17、TNF-α、hs-CRP均显著低于对照组,其差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】吡格列酮联合二甲双胍治疗激素抵抗性PCOS不孕患者,可有效提高临床疗效,可改善血糖代谢和性激素水平,抑制炎性反应,且安全性较高,值得临床推广应用。

【Objective】To observe the effects of pioglitazone and metformin on the levels of sex hormones and inflammatory factors in the treatment of infertility with hormone resistant polycystic ovary syndrome(PCOS).【Methods】A total of 120 infertile patients with hormone resistant PCOS were randomly divided into the observation group(n=60)and the control group(n=60).The control group was treated with metformin alone and the observation group was treated with pioglitazone in addition to metformin.The clinical efficacy,adverse reactions,insulin resistance(IR)index before and after treatment[fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR)],sex hormone[follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),estradiol(E2)]level and inflammation related index[interleukin 6(IL-6),interleukin-17(IL-17),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)]were compared between the two groups.【Results】The total effective rate in the observation group was 95.00%,which was significantly higher than 80.00%in the control group(P<0.05).After treatment,FPG,FINS,HOMA-IR,FSH,LH,T,E2,IL-6,IL-17,TNF-αand hs-CRP were significantly decreased in the two groups compared with before treatment(P<0.05).Levels of FPG,FINS,HOMA-IR,FSH,LH,T,E2,IL-6,IL-7 TNF-αand hs-CRP in the observation group after treatment were significantly lower than those in the control group;And the differences were statistically significant(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】On the basis of metformin in the treatment of hormone resistant PCOS infertility,pioglitazone can effectively improve the clinical efficacy,which can have obvious blood glucose metabolism improvement,adjust the level of sex hormones,inhibit the inflammatory reaction.Safety of the drug is high,so it is worthy of clinical promotion.