维生素D联合屈螺酮炔雌醇及罗格列酮治疗肥胖PCOS不孕伴胰岛素抵抗的效果观察

Effect of Vitamin D Combined with Drospirosterone Ethinylestradiol and.Rosiglitazone in the Treatment of Obesity PCOS Infertility with Insulin Resistance

目的观察分析在屈螺酮炔雌醇及罗格列酮的基础上联合维生素D治疗肥胖型多囊卵巢综合征(PCOS)伴不孕及胰岛素抵抗的效果。方法选取2020年1月至2022年3月期间我院收治的80例肥胖型PCOS伴不孕及胰岛素抵抗患者,将患者随机分为常规组40例与实验组40例。常规组患者予以屈螺酮炔雌醇联合罗格列酮治疗,实验组患者在常规组的基础上联合使用维生素D,分析两组患者治疗前后体重指数、血糖水平、胰岛素抵抗指数、雄激素水平、排卵率及受孕率、不良反应发生率的差异。结果治疗后,两组患者的BMI、胰岛素抵抗指数、空腹血糖、餐后2 h血糖水平、血清促黄体生成素、睾酮水平均较治疗前降低,且实验组患者低于常规组患者(P<0.05);随访6个月,实验组排卵率及受孕率均高于常规组(P<0.05);两组不良反应发生率比较无差异(P>0.05)。结论维生素D联合屈螺酮炔雌醇及罗格列酮用于治疗肥胖型PCOS伴不孕及胰岛素抵抗患者效果确切,能够降低血糖及胰岛素抵抗,下调雄激素,提高排卵率及受孕率。

Objective Observation and analysis of the effect of vitamin D combined with drospiroestradiol and rosiglitazone on infertility with insulin resistance in obese patients with polycystic ovary syndrome(PCOS).Methods 80 patients of obese PCOS with infertility and insulin resistance admitted to our hospital from January 2020 to March 2022,and randomly divided into 40 patients in the conventional group and 40 patients in the experimental group.Patients in the conventional group were treated with drospiroxestradiol combined with rosiglitazone,and the experimental group was treated with vitamin D on the basis of the conventional group.Blood glucose,insulin resistance index,androgen level,ovulation rate,pregnancy rate,and incidence of adverse reactions were analyzed and compared between the two groups before and after treatment.Results After treatment,the BMI,insulin resistance index,fasting blood glucose,2 h postprandial blood glucose level,serum luteinizing hormone and testosterone levels were lower than before treatment,and the experimental group was lower than those in the conventional group(P<0.05);after 6 months of follow-up,the ovulation rate and conception rate were higher than the conventional group(P<0.05);there was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Vitamin D combined with drospiroestradiol and rosiglitazone is effective in the treatment of obese PCOS infertility patients with insulin resistance,which can reduce blood sugar and insulin resistance,reduce hyperandrogen,and increase ovulation and pregnancy rate.