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·腹部疾病·

二甲双胍对PCOS并糖代谢异常患者血清脂联素、总氧化态及 胰岛素抵抗的影响

作者:邢宇瑞

所属单位:河南省开封市妇幼保健院妇科 (河南 开封 475000)

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摘要

目的 观察二甲双胍对多囊卵巢综合征(PCOS)并糖代谢异常患者血清脂联素、总氧化态及胰岛素抵抗的影响。方 法 将112例PCOS并糖代谢异常患者,随机分为观察组和对照组,两组均给予去氧孕稀炔雌醇片治疗,观察组在此基 础上加用盐酸二甲双胍片治疗,观察比较治疗前后两组患者血清脂联素(APN)水平、胰岛素指数及一氧化氮(NO)、 总抗氧能力(TAC)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平。结果 治疗后,两组患者血清APN水平较治疗前均有 升高,但对照组较治疗前差异无统计学意义(P>0.05),且观察组较对照组APN水平升高更显著,差异有统计学意义 (P<0.05)。治疗后,对照组HOMA-IR较治疗前无显著变化(P>0.05),但观察组较治疗前HOMA-IR明显减小,且与对照 组比亦明显减小,差异均有统计学意义(P<0.05)。治疗后,对照组较治疗前上述四个指标均无显著变化(P>0.05); 而观察组较治疗前NO、MDA水平均明显降低,TAC、SOD水平明显升高,差异有统计学意义(P<0.05)。结论 二甲双胍 可升高PCOS并糖代谢异常患者血清APN水平,改善胰岛素抵抗及总氧化态,促进病情缓解。

Objective To observe the influence of Metformin in adiponectin, total oxidation and insulin resistance of patients with PCOS and abnormal glucose metabolism. Methods A total of 112 cases of patients with PCOS and abnormal glucose metabolism were divided into observation group and contrast group randomly with each group 56 cases. Patients in both groups were given desogestrel and ethinylestradiol tablets treatment. Meantime, patients in the observation group were given Metformin based on desogestrel and ethinylestradiol tablets treatment. Observe and compare the APN level, insulin index as well as the levels of NO, TAC, MDA and SOD between both groups. Results The APN levels of after treatment in both groups were more raised than those of before treatment. In the contrast group, the difference of APN levels of before and after treatment showed no statistical significance (P>0.05). The APN levels in the observation group were more significantly raised than those in the contrast group. The difference showed s statistical significance (P<0.05). In the contrast group, the HOMA-IR of after treatment was not significantly different with that of before treatment. The difference showed s statistical significance (P<0.05). In the contrast group, the levels of NO, TAC, MDA and SOD of after treatment were not significantly different with those of before treatment (P>0.05). While in the observation group, the levels of NO and MDA were significantly more decreased and the levels of TAC and SOD were significantly more increased. The difference showed s statistical significance(P<0.05). Conclusion Metformin can increase the APN level of the patients with PCOS and abnormal glucose metabolism, improve the insulin resistance and total oxidation, and then promote to relieve the patients’ state of illness.

【关键词】二甲双胍;多囊卵巢综合征;糖代谢异常;脂联素;总氧化态;胰岛素抵抗

【中图分类号】R71;R47

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2017.04.017

前言

多囊卵巢综合征(polycystic ovary syndrome, PCOS)是一种以月经紊乱、不孕为主要临床症状的常 见妇科疾病,其可引起糖代谢异常、脂肪代谢异常、 子宫内膜癌等,对妇女身心健康造成巨大影响[1]。 研究认为,胰岛素抵抗(HOMA-IR)和高胰岛素血症是 PCOS发生主要病理基础,而脂肪组织分泌因子脂联素(APN)可能与胰岛素抵抗发生有关[2-3]。二甲双胍是一 种常用于治疗PCOS的口服降糖药,本文旨在观察二甲 双胍对多囊卵巢综合征(PCOS)并糖代谢异常患者血清 脂联素、总氧化态及胰岛素抵抗的影响,为临床治疗 提供依据。