司美格鲁肽联合二甲双胍对肥胖型多囊卵巢综合征患者内分泌代谢及妊娠结局的影响

Effects of Semiglutide combined with Metformin on Endocrine Metabolism and Pregnancy Outcomes in Obese Patients with Polycystic Ovary Syndrome

目的探讨司美格鲁肽联合二甲双胍对肥胖型多囊卵巢综合征(PCOS)患者内分泌代谢及妊娠结局的影响。方法选取2019年1月至2022年1月滕州市中医医院收治的86例肥胖型PCOS患者作为研究对象,采用随机数字表法分为对照组与观察组,各43例。对照组予以炔雌醇环丙孕酮片,观察组在对照组基础上采用司美格鲁肽联合二甲双胍治疗。比较两组患者临床疗效,治疗前后脂代谢指标、体重指数(BMI)以及性激素水平,不良反应发生情况,对所有患者进行1年随访记录其妊娠率及成功分娩率。结果观察组治疗有效率高于对照组(P<0.05);治疗后两组高密度脂蛋白胆固醇(HDL-C)水平升高,且观察组高于对照组,两组三酰甘油(TG)、BMI水平降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后两组雌二醇(E_(2))水平升高,且观察组高于对照组,两组卵泡刺激素(FSH)、黄体生成素(LH)水平降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05);观察组妊娠率及成功分娩率高于对照组(P<0.05)。结论采用司美格鲁肽联合二甲双胍治疗肥胖型PCOS临床疗效显著,可有效改善患者脂代谢、性激素水平,降低BMI,提升妊娠率和成功分娩率,且安全性较高。

Objective To explore the effects of semiglutide combined with metformin on endocrine metabolism and pregnancy outcome in obese patients with polycystic ovary syndrome(PCOS).Methods A total of 86 obese PCOS patients admitted to Tengzhou Hospital of Traditional Chinese Medicine from January 2019 to January 2022 were selected as research objects,and were divided into control group and observation group by random number table method,with 43 cases in each group.The control group was given ethinestradiol cyproterone tablets,and the observation group was treated with semaglutide combined with metformin on the basis of the control group.The clinical efficacy,lipid metabolism indexes,body mass index(BMI)and sex hormone levels before and after treatment,and the occurrence of adverse reactions were compared between the two groups.All patients were followed up for 1 year to record their pregnancy rate and successful delivery rate.Results The effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the high density lipoprotein cholesterol(HDL-C)level of the two groups was increased,and the observation group was higher than the control group,the triglyceride(TG)and BMI levels of the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).After treatment,the estradiol(E_(2))level of the two groups was increased,and the observation group was higher than the control group,the follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels of the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The pregnancy rate and successful delivery rate of observation group were higher than those of control group(P<0.05).Conclusion The combination of semiglutide and metformin in the treatment of obese PCOS is clinically ideal and significant,which can effectively improve the lipid metabolism and sex hormone levels of patients,reduce BMI,and increase the pregnancy rate and successful delivery rate,with high safety.