吡格列酮联合炔雌醇环丙孕酮对肥胖型PCOS疗效及血清HP、FABP、IGFBP-3的影响

Effect of pioglitazone combined with ethinylestradiol and cycloproprogesterone on the curative effect of obese PCOS and the serum levels of HP,FABP and IGFBP-3

目的探讨吡格列酮联合炔雌醇环丙孕酮对肥胖型多囊卵巢综合征(PCOS)疗效及血清触珠蛋白(HP)、脂肪酸结合蛋白(FABP)、胰岛素样生长因子结合蛋白-3(IGFBP-3)的影响。方法选取肥胖型PCOS患者82例,随机等分为对照组(炔雌醇环丙孕酮)和联合组(吡格列酮+炔雌醇环丙孕酮)。比较两组治疗总有效率,治疗前后性激素[睾酮(TS)、雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)]、糖脂代谢指标[甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、空腹血胰岛素(FINS)、空腹血糖(FBG)],以及血清HP、FABP、IGFBP-3水平和不良反应情况。结果联合组治疗总有效率高于对照组(P<0.05)。治疗后,两组E2、TS、LH、FSH、TG、FBG、FINS、HP、FABP、IGFBP-3均低于治疗前,HDLC水平高于治疗前(P<0.05);且联合组改善较对照组更为显著(P<0.05)。联合组不良反应发生率与对照组比较差异无显著性(P>0.05)。结论吡格列酮联合炔雌醇环丙孕酮治疗肥胖型PCOS疗效显著,可下调患者血清HP、FABP、IGFBP-3水平。

Aim To investigate the effect of pioglitazone combined with ethinylestradiol and cyclopropesterone on obese polycystic ovary syndrome(PCOS)and the effect of serum haptoglobin(HP),fatty acid binding protein(FABP)and insulin-like growth factor binding protein-3(IGFBP-3).Methods Eighty two obese PCOS patients were randomly divided into control group(ethinylestradiol cycloproprogesterone)and combination group(pioglitazone+ethinylestradiol cycloproprogesterone).The effective rateof treatment,sex hormones(testosterone(TS),estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)),glucose and lipid metabolism indexes(triglycerides(TG),high-density lipoprotein cholesterol(HDLC),fasting blood insulin(fins),fasting blood glucose(FBG)),serum HP,FABP,IGFBP-3 and adverse reactions were compared between the two groups before and after treatment.Results The effective rate of the combined group was higher than the control group(P<0.05).After treatment,E2,TS,LH,FSH,TG,FBG,fins,HP,FABP and IGFBP-3 in both groups were lower than those before treatment,and HDLC level was higher than that before treatment(P<0.05);And the improvement of the combined group was more significant than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group and the control group(P>0.05).Conclusion Pioglitazone combined with ethinylestradiol and cycloproprogesterone has a significant effect on the treatment of obese PCOS,and can down regulate the serum levels of HP,FABP and IGFBP-3.