胃肠道脂肪酶抑制剂联合双胍类降糖药对肥胖伴多囊不孕女性血清雌激素水平的影响

摘要

Objective To investigate the effect of gastrointestinal lipase inhibitor combined with biguanides on serum estrogens in the treatment of polycystic ovary syndrome with infertility in patients.Methods 72 cases with polycystic ovary syndrome with infertility from Huangyan Hospital Affiliated to Wenzhou Medical University were selected and randomly divided into 2 groups, 36 cases of each group.The control group received conventional therapy, and the treatment group received more with orlistat, serological indicators, clinical symptoms, signs, pregnancy rate and ovulation rate were compared after the treatment.Results Compared with control group, levels of blood glucose and blood lipid index decreased in treatment group after treatment (P<0.05), the levels of luteinizing hormone (LH), follicles estrogen (FSH), estradiol (E2) and testosterone (T) decrease(P<0.05), levels of visfatin (VF) and leptin (LEP) decreased(P<0.05), adiponectin (APN) increased(P<0.05), and levels of BMI, WHR, hirsutism score and ovarian volume decreased (P<0.05).Compared with the control group(69.44%, 55.56%), the ovulation rate and pregnancy rate in the treatment (91.67%, 80.56%) were higher(P<0.05).Conclusion Gastrointestinal lipase inhibitor combined with biguanides could improve the pregnancy rate and ovulation rate in patients with polycystic ovary syndrome with infertility, reduce the levels of estrogens.%目的：探讨胃肠道脂肪酶抑制剂联合双胍类降糖药对肥胖伴多囊不孕女性血清雌激素水平的影响。方法选取温州医科大学附属黄岩医院内分泌代谢科诊断肥胖伴多囊不孕女性72例，随机分为2组，各36例，对照组予以常规治疗，研究组在常规治疗基础上予以联合奥利司他治疗，采血测定血清学指标，观察临床症状、体征，同时对比妊娠率和排卵率。结果与对照组相比，研究组治疗后血糖和血脂相关指标降低（P＜0.05），黄体生成素（luteinizing hormone，LH）、卵泡雌激素（follicles estrogen，FSH）、雌二醇（estradiol，E2）及睾酮（testosterone，T）水平含量降低（P＜0.05），内脂素（visfatin，VF）、瘦素（leptin，LEP）含量降低（P＜0.05），脂联素（adiponectin，APN）含量升高（P＜0.05），体重指数（BMI）、腰臀比（MHR）、多毛评分及卵巢体积降低（P＜0.05）；与对照组排卵率（69.44％）相比，研究组排卵率（91.67％）较高（P＜0.05），与对照组妊娠率（55.56％）相比，研究组妊娠率（80.56％）较高（P＜0.05）。结论胃肠道脂肪酶抑制剂联合双胍类降糖药能提高肥胖伴多囊不孕女性的妊娠率和排卵率，降低雌激素水平。