利拉鲁肽联合二甲双胍对多囊卵巢综合征不孕患者的治疗效果

Therapeutic Effect of Liraglutide Combined with Metformin for Infertile Patients with Polycystic Ovary Syndrome

目的:分析利拉鲁肽联合二甲双胍对多囊卵巢综合征(PCOS)不孕患者的治疗效果。方法:前瞻性选取2017年1月—2020年1月于蕲春县人民医院就诊的80例PCOS不孕患者作为研究对象。采用随机数表法将患者分为利拉鲁肽联合组与二甲双胍组,各40例。二甲双胍组接受盐酸二甲双胍片口服,利拉鲁肽联合组在二甲双胍组基础上接受利拉鲁肽注射液皮下注射,两组均治疗3个月,并随访1年。观察两组治疗3个月后的效果,比较两组治疗前、治疗3个月后血清糖代谢指标、脂代谢指标及性激素水平,记录两组随访期间排卵及妊娠情况。结果:治疗3个月后,利拉鲁肽联合组总有效率为95.00%,高于二甲双胍组的80.00%,差异有统计学意义(P<0.05)。随访期间,利拉鲁肽联合组排卵率、妊娠率分别为92.50%、72.50%,高于二甲双胍组的67.50%、42.50%,差异有统计学意义(P<0.05)。治疗3个月后,两组血清糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、睾酮(T)、催乳素(PRL)、基础卵泡刺激素(FSH)水平低于治疗前,且利拉鲁肽联合组低于二甲双胍组,差异有统计学意义(P<0.05);治疗3个月后,两组血清高密度脂蛋白胆固醇(HDL-C)水平高于治疗前,且利拉鲁肽联合组高于二甲双胍组,差异有统计学意义(P<0.05)。结论:利拉鲁肽联合二甲双胍可有效改善PCOS不孕患者的糖脂代谢,同时可降低血清性激素水平,临床治疗效果显著,有助于提高排卵率及妊娠率。

Objective:To analyze the therapeutic effect of Liraglutide combined with Metformin for infertile patients with polycystic ovary syndrome(PCOS).Method:From January 2017 to January 2020,80 infertility patients with PCOS who treated in Qichun People's Hospital were prospectively selected as the research subjects,the patients were divided into Liraglutide combined group and Metformin group according to the random number table method,with 40 cases in each group.The Metformin group was given Metformin Hydrochloride Tablets orally,and the Liraglutide combined group was given subcutaneous injection of Liraglutide Injection on the basis of the Metformin group,two groups were treated for 3 months and followed-up for 1 year.The therapeutic effects of two groups after 3 months of treatment were observed,the serum levels of glucose metabolism indexs,lipid metabolism indexs and sex hormone of two groups before and after 3 months of treatment were compared,and the ovulation and pregnancy of two groups during followed-up were recorded.Result:After 3 months of treatment,the total effective rate of the Liraglutide combined group was 95.00%,which was higher than 80.00%of the Metformin group,the difference was statistically significant(P<0.05).During the followed-up,the rate of ovulation and pregnancy in the Liraglutide combined group were 92.50%and 72.50%,respectively,which were higher than 67.50%and 42.50%in the Metformin group,the differences were statistically significant(P<0.05).After 3 months of treatment,the serum levels of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),fasting insulin(FINS),homeostasis model insulin resistance(HOMA-IR),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),testosterone(T),prolactin(PRL),basal follicle stimulating hormone(FSH)in two groups were lower than those before treatment,and those in the Liraglutide combined group were lower than those in the Metformin group,the differences were statistically significant(P<0.05).After 3 months of treatment,the serum level of high density lipoprotein cholesterol(HDL-C)in two groups were higher than those before treatment,and that in the Liraglutide combined group was higher than that in the Metformin group,the differences were statistically significant(P<0.05).Conclusion:Liraglutide combined with Metformin could effectively improve the glucose and lipid metabolism of infertile patients with PCOS,and reduce the serum levels of sex hormone,the clinical treatment effect is remarkable,which is helpful to improve the ovulation rate and pregnancy rate.