关于72例多囊卵巢综合征患者临床资料和胰岛素抵抗相关临床指标的观察分析

摘要

目的：分析多囊卵巢综合征(polycystic ovarian syndrome，PCOS)女性的临床特征与胰岛素抵抗(insulin resistance，IR)临床指标的关系。方法：选取2013年1月至2015年3月于本院内分泌科治疗的PCOS患者72例患者作为研究对象并根据是否合并有胰岛素抵抗分为两个亚组；同时，按随机表选取同期就诊于本院健康体检中心的55名育龄期女性作为对照组，收集比较各组一般临床资料、激素及生化指标、血糖及胰岛素，计算胰岛素抵抗、胰岛β细胞功能参数。结果：研究组较对照组BMI、SBP、血脂指标(TC、TG)、血尿酸(serum uric acid，SUA)显著升高，两组年龄、DBP相比差异无统计学意义(P>0.05)；研究组IR发生率高于对照组(P<0.05)；研究组非IR亚组患者激素水平与对照组相比，研究组血清促卵泡激素(follicle-stimulating hormone，FSH)、促黄体生成素(luteotropic hormone，LH)、睾酮(T)、雌二醇(E2)升高，LH/FSH比值增大，而研究组内两亚组比较，各项指标均无统计学意义(P>0.05)；研究组中两亚组IR参数比较，合并有IR亚组的患者HOMA-IR、FPG/FINS较非IR亚组升高，差异有统计学意义(P<0.05)，而HOMA-IAI、ISI comp、FPG/FINS较非IR亚组显著降低(P<0.05)，SG/SI比值两亚组比较差异无统计学意义(P>0.05)；两亚组胰岛β细胞功能参数比较，合并IR亚组患者HOMA-IS较非IR亚组降低，结果有统计学意义(P<0.05)，两组ΔI30/ΔG30及DI值比较未见统计学差异(P>0.05)。结论：PCOS患者中胰岛素抵抗发生率高于正常人群，胰岛素抵抗通过多种途径提高了机体患多囊卵巢综合征的可能性，同时增加了患者发生糖脂代谢及内分泌紊乱的风险，对于患有PCOS的患者是否合并有胰岛素抵抗，对性激素水平干扰无差别。%Objective: To analyze the relationship between clinical features and clinical parameters of insulin resistance (IR)in the women with polycystic ovary syndrome (PCOS).Methods: Selected 72 cases of PCOS patients who were treated in our hospital from January 2013 to March 2015 as the study group, and divided into IR subgroup and non-IR subgroup according to whether or not the patients were associated with IR. And 55 cases of health women in child-bearing age were chosen as the control group. hTe general clinical data, hormone and biochemical indexes, blood glucose and insulin were collected and compared between the 2 groups. Insulin resistance and beta cell function parameters were calculated.Results: Compared with the control group, BMI, SBP and blood lipid index (TC, TG), and serum uric acid (SUA) in the study group increased signiifcantly, while age and DBP had no signiifcant difference (P>0.05); the incidence of IR in the study group is higher than that of control group (P<0.05); compared the hormone levels with the control group the study group, serum follicle-stimulating hormone (FSH), luteotropic hormone (LH), T, E2 in non-IR subgroups of the study group increased, and LH/FSH ratio increased; while compared between the two subgroups, the indicators were not statistically significant (P>0.05); compared the IR parameters between the two subgroups in the study group, HOMA-IR and FPG/FINS in IR subgroup increased significantly than those in the non-IR subgroup, the difference was statistically significant (P<0.05), while HOMA-IAI, ISI comp, and FPG/FINS decreased signiifcantly those in non-IR subgroup (P<0.05); as for the SG/SI ratio, there was no signiifcant difference between two groups (P>0.05); comparison of islet beta cell function parameters in two subgroups, HOMA-IS in IR subgroup was lower than that in non-IR subgroup, there was signiifcant difference (P<0.05). ΔI30/ΔG30 and DI value of the two groups showed no signiifcant difference (P>0.05).Conclusion: Insulin resistance rate in PCOS patients is higher than those in the normal population, insulin resistance improves the possibility of polycystic ovarian syndrome through a variety of ways, and increases the risk of glucose and lipid metabolism and endocrine disorders in patients. For patients with PCOS patients with or without insulin resistance has no difference with the disturbance of sex hormone level.