纳米铜复合材料宫内节育器对家兔子宫内膜超微结构的影响

目的:评价纳米铜/低密度聚乙烯复合材料宫内节育器(IUD)的安全性。方法:实验家兔分为对照组、裸铜组、低剂量纳米铜组(0.5-1.0μg/d)和高剂量纳米铜组(1.1-2.0μg/d)。于置器后56d取子宫内膜做扫描电镜和透射电镜检查。结果:裸铜组家兔子宫内膜上皮细胞微绒毛排列不规则,胞浆内出现大空泡,微丝结构增多,粗面内质网扩张,细胞间连接装置变宽。纳米铜组家兔子宫内膜上皮细胞微绒毛脱落,细胞形态基本正常,细胞核结构正常,胞浆内粗面内质网轻度扩张,细胞间连接装置正常。结论:形态学改变相比较说明纳米铜IUD对家兔子宫内膜超微结构影响较轻,对子宫内膜的刺激作用较小,从而可能会减少置IUD初期子宫异常出血、疼痛等不良反应的发生。     

消炎痛对人子宫内膜细胞摄取前列腺素E_2的影响

<正> 放置宫内节育器(IUD)后的一个最常见的副反应是子宫异常出血。近十多年来,这种副反应与放置IUD后子宫前列腺素(PGs)的生物合成异常以及子宫对PGs的敏感性增强的关系愈来愈明确。临床使用消炎痛PGs合成酶抑制,能有效地防治IUD子宫异常出血,但具体的作用途径尚不明确。PGs对子宫内膜细胞产生效应,首先必须由子宫内膜细胞将PGs摄入细胞内。本文用细胞摄取功能测定法,观察人子宫内膜细胞摄取[~3H]PGE_2的功能状态及其在消炎痛作用后的变化,从中探索消炎痛影响子宫内膜细胞与     

宫内节育器对大鼠子宫内膜血管内皮生长因子及其受体表达影响的研究

目的:研究置固定式铜宫内节育器(FCu-IUD)和固定式吲哚美辛铜宫内节育器(FICu-IUD)的大鼠子宫内膜组织中血管内皮生长因子(VEGF)及其受体Flk-1的表达。方法:采用蛋白印迹法(Western blotting)检测FCu-IUD组、FICu-IUD组大鼠子宫内膜组织VEGF及Flk-1的表达,逆转录聚合酶联反应(RT-PCR)检测各组VEGF mRNA的表达。以未置器一侧作为对照。结果:大鼠置器侧与对照侧子宫内膜均可检测到与VEGF121和VEGF165两种VEGF亚型相对应的mRNA与蛋白表达。FCu-IUD组大鼠置器侧子宫内膜VEGF121及VEGF165表达在mRNA水平和蛋白水平均显著升高,与对照侧比较差异有统计学意义(P<0.001,P<0.05)。置器侧Flk-1蛋白的表达明显高于对照侧(P<0·01)。FICu-IUD组置器侧与对照侧比较,VEGF、Flk-1蛋白及VEGF mRNA表达差异均无显著性。结论:Cu-IUD引起的子宫异常出血可能与VEGF的增加有关,吲哚美辛减少Cu-IUD引起的子宫异常出血的作用可能与通过抑制前列腺素合成从而使VEGF生成减少有关。     

CuIUD对妇女子宫内膜环氧化酶表达的影响

目的:　研究置固定式铜宫内节育器(FCuIUD)前后妇女子宫内膜组织中环氧化酶(COX-1、COX-2)的表达。方法:　选择符合受试条件的育龄妇女10 例,于月经净后3-7　d放置FCuIUD,置器前及置器后一个月于相同时期、相同部位刮取子宫内膜。RT-PCR法与Western　blot法分析放置FCu-IUD前后妇女子宫内膜组织COX-1、COX-2　mRNA及蛋白表达水平。免疫组化S-P法测定COX-2在子宫内膜的定位与分布。结果:置FCuIUD一个月后,子宫内膜COX-2　mRNA和蛋白表达水平均显著增加,与置器前比较,差异显著(P<0.05)。COX-1　mRNA及蛋白的表达在置器前后无明显差异。COX-2主要分布于腺上皮细胞的胞浆内。结论:　置FCuIUD后妇女子宫内膜COX-2表达在转录和翻译水平均显著增加;COX-2可能是节育器引起的无菌性炎症中PGs释放增加的主要同工酶。     

宫内节育器引起子宫出血原因的研究

对61例置器组及14例正常对照组的子宫内膜进行光镜、扫描电镜及透射电镜的观察;并采用组织化学方法测定子宫内膜组织的纤溶活性、上皮细胞酸性磷酸酶、碱性磷酸酶活性及糖原含量的变化,探索子宫出血的原因。发现:IUD可引起子宫内膜表面立体结构及内膜超微结构的改变,上皮细胞变性,内膜浅层血管内皮细胞变性、甚至断裂形成裂缝,但无凝血现象;血管充血,且密度增加,内膜间质水肿、出血炎性细胞浸润;内膜纤溶活性增强;增生期内膜上皮细胞酸性磷酶活性增强,碱性磷酸酶活性减弱;分泌期内膜上皮细胞糖原含量减少且在腺体间的分布不均。以上多种因素综合作用导致置器后异常的子宫出血。     

记忆合金药铜宫内节育器对兔子宫内膜超微结构的影响

目的:研究记忆合金药铜节育器对兔子宫内膜超微结构的影响。方法:雌性日本大耳白兔随机分为3组,实验组记忆合金药铜节育器和对照组不锈钢药铜节育器各18只,假手术对照组6只,通过手术放置节育器于兔子宫腔内,术后1、3、6个月处死兔,取出子宫,扫描和透射电子显微镜下观察放置节育器处的子宫内膜。结果:放置节育器的兔子宫内膜均可见上皮细胞的形态和结构发生改变。扫描电子显微镜下,上皮细胞的变化随节育器放置时间和受压程度的增加而增加,可逐渐出现细胞表面压平、变形,微绒毛稀疏、消失;较长时间放置,可引起上皮细胞损坏、脱落。透射电子显微镜下2种节育器引起的细胞形态和结构的改变相似,主要是内质网扩张,细胞核肿胀,质膜溶解,严重的可见上皮细胞脱落现象。细胞内超微结构的损伤亦随节育器放置时间和受压程度的增加而加重。但基膜始终损伤较轻微,基膜下的间质未观察到明显异常的形态学变化。结论:记忆合金药铜节育器与不锈钢药铜节育器对兔子宫内膜超微结构的影响相似。     

消炎痛Vcu200 IUD减少月经过多的机理

自１９９２年１１月至１９９５年６月，对４６例放置无消炎痛ＶＣｕ２００ＩＵＤ及２４例含消炎痛ＶＣｕ２００ＩＵＤ妇女的子宫内膜中６－ｋｅｔｏ－ＰＧＦ１α、ＴＸＢ２及纤溶指标包括ｔ－ＰＡ、ＰＡＩ、ＰＫ、ＰＬＧ、Ｄ－Ｄ及ＦＤＰ的水平进行测定，同时作光、电镜观察置器后ＩＵＤ对子宫内膜的影响。结果：１．无消炎痛ＶＣｕＩＵＤ３月组置器后６－ｋｅｔｏ－ＰＧＦ１α／ＴＸＢ２比值明显高于置器前（Ｐ＜０．０５），ｔ－ＰＡ、ＰＫ、ＰＬＧ、Ｄ－Ｄ及ＦＤＰ均非常明显低于置器前水平（Ｐ＜０．ｏ１～０．００１）。２．无消炎痛ＶＣｕＩＵＤ＞６月组置器后只ｔ－ＰＡ、ＰＫ、ＦＤＰ明显低于置器前水平（Ｐ＜０．０１～０．００１），其余指标均无统计学差异。３．放置合消炎痛ＶＣｕＩＵＤ３个月后６－ｋｅｔｏ－ＰＧＦ１α、ＴＸＢ２及各项纤溶指标与置器前比均无统计学意义。４．子宫内膜形态学变化与置器前相比，表现为血管内血栓形成减少及末梢小血管腔扩大。根据上述结果，置器后内膜中６－ｋｅｔｏ－ＰＧＦ１α／ＴＸＢ２值升高，与ｔ－ＰＡ水平下降可能是置器后月经过多的主要原因，尤以前者起主导作用。本文并对消炎痛ＩＵＤ减少月经过多的作用机理进行了讨论。     

左炔诺孕酮宫内缓释系统治疗功能失调性子宫出血的临床观察

目的:观察左炔诺孕酮宫内缓释系统(LNG-IUS)治疗功能失调性子宫出血的临床效果。方法:48例确诊为功能失调性子宫出血的患者,放置LNG-IUS。置宫内节育器前后均行宫腔镜检查、月经量评分、测量子宫内膜厚度;检测卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)和孕酮(P)浓度及子宫内膜雌、孕激素受体(ER/PR)。结果:置宫内节育器3个月后,月经量明显减少,PBAC法月经量评分由置宫内节育器前(128.9±41.5)降至(52.2±13.8),具有统计学意义(P<0.01);子宫内膜由(12.9±4.2)mm降至(8.4±2.0)mm,差异具有统计学意义(P<0.05)。置宫内节育器6个月后,宫腔镜下观察,子宫内膜菲薄,病理显示内膜呈轻度分泌现象及间质蜕膜样变;ER、PR的表达均显著下调(P<0.01)。结论:LNG-IUS能有效地减少月经量,对增生的子宫内膜具有逆转作用,治疗功能失调性子宫出血效果好。     

应用宫内节育器的妇女沙眼衣原体感染与子宫内膜中铜含量的关系

目的:探讨女性生殖道沙眼衣原体(CT)感染与宫内节育器(IUD)种类及内膜中铜含量的关系。方法:用聚合酶链反应检测65例置含铜IUD及97例置不锈钢单环的妇女宫颈分泌物CT;对因症取出IUD的20例妇女,取器后刮取子宫内膜,用原子吸收分光光度法测子宫内膜铜含量。结果:放置含铜IUD者CT感染率(3.1%)明显低于置不锈钢单环者(12.3%),P<0.05;放置含铜IUD的妇女子宫内膜铜含量明显高于置不锈钢单环者(P<0.05)。结论:含铜IUD对生殖道CT感染有抑制作用。含铜IUD可能通过释放的铜离子来发挥抗CT作用。     

含消炎痛IUD对家兔子宫内膜影响的酶组织化学观察

本文采用酶组织化学方法观察了含消炎痛IUD对家兔子宫内膜几种酶的影响,并与全铜、硅胶及铜加消炎痛IUD进行了比较.结果表明:(1)含消炎痛IUD组子宫内膜NSE、SDII和ATPase三种酶活性增强;全铜IUD组则上述三种酶活性明显下降;加消炎痛的含铜IUD组子宫内膜酶活性低于含消炎痛IUD组,但高于硅胶对照组.(2)全铜IUD组子宫内膜损伤较明显.由此可见,含消炎痛IUD对子宫内膜上皮功能及结构的损害均小于含铜IUD.     

人工流产术后即时放置三种宫内节育器的多中心随机对照研究

目的 了解3种常用宫内节育器(IUD)在人工流产术后即时放置的临床效果和安全性.方法 通过前瞻性随机对照临床研究,对来自全国7个省市的12个协作中心的1800例研究对象于人工流产术后即时放置IUD,放置的IUD类型分为宫形含铜IUD宫铜200、T形含铜IUDTCu380A和活性γ型IUD 3种,每种分别观察600例,并随访12个月.结果 1798例完成了使用12个月的随访,2例失访(失访率为0.11%,2/1800);17例不符合纳入标准的未产妇资料在进行数据统计分析时被剔除.3种IUD使用者均未发生妊娠(或带器妊娠),且均无子宫穿孔、IUD异位等并发症发生.活性γ型IUD的医疗原因终止率为1.02/百妇女年,低于宫铜200、TCu380A(分别为3.60/百妇女年、2.25/百妇女年),3者比较,差异有统计学意义(P=0.015).宫铜200、TCu380A和活性.y型IUD中,与IUD使用相关的终止率分别为7.58/百妇女年、7.30/百妇女年和3.72/百妇女年,3者比较,差异有统计学意义(P=0.008).结论 人工流产术后即时放置宫铜200、TCu380A和活性γ型IUD的避孕效果均良好,均安全可行,尤其是国产活性γ型IUD,值得推广.     

含不同剂量消炎痛γ型IUD比较性研究

本研究对三种含不同剂量消炎痛的ｒ－ＩＵＤ进行比较性研究，即含消炎痛２５±３ｍｇ，１８±２ｍｇ和不含消炎痛的γ－ＩＵＤ对照组各３００例，共９００例，于１９９２年１０月～１９９３年５月放置，放置后进行定期随访，随访率１００％，资料按生命表法统计一年时三组ＩＵＤ累计妊娠和脱落率均甚低。因症取出率以无药组最高为３．０５，一年时继续存放率γ２５ＩＵＤ组为９８．６６，γ１８ＩＵＤ组为９８．３３均明显高于γ０ＩＵＤ组的９４．３２／１００妇女，三组各测月经血量１５例，均与放置前比较，γ２５ＩＵＤ组放置后３～１２月月经量可减少３３．５～５．２％，γ１８ＩＵＤ组无明显改变，γ０ＩＵＤ组月经量有所增加。研究结果说明在三种ＩＵＤ中γ２５ＩＵＤ组含消炎痛量为较合理的配伍剂量。     

The role of copper-releasing intrauterine device or levonorgestrel-releasing intrauterine system on uterine bleeding and iron status (prospective study of 8 years)

BACKGROUND: The aims of this study were the effects of copper intrauterine device (Cu-IUD) compared to progesterone (PRG-IUS) or levonorgestrel releasing intrauterine system (LNg-IUS) on menstrual bleeding, menorrhagia and dysfunctional uterine bleeding. The authors evaluated the effect of copper surface area on uterine bleeding. METHODS: Between March 1992 and November 1999, 223 women, referred to I Institute of Obstetrics and Gynaecology University of Rome, were recruited in a prospective study with follow up at 3, 6 and 12 months to evaluate the incidence of endometrial pathology. The study includes 38 fertile women with regular menstruations and without intrauterine devices, as control group, and 185 patients with intrauterine devices, divides as follows: - 117 copper-releasing intrauterine devices: 30 with a copper (Cu) surface area =200 mm2, releasing 45 microgram Cu/24h (Nova T (R)); 27 with a copper surface area =250 mm2, releasing 50 microgram Cu/24h (Multiload 250 (R)); 25 with a copper surface area =375 mm2, releasing 65 microgram Cu/24h (Multiload 375 (R)); 20 with a copper surface area =384 mm2, releasing 100 microgram Cu/24h (No Gravid M (R)); 15 with a copper surface area =440 mm2, releasing 120 microgram Cu/24h (No Gravid 0,5 (R)). - 68 progesterone/levonorgestrel-releasing intrauterine devices: 40 progesterone-releasing intrauterine systems (Progestasert(R)); 28 levonorgestrel-releasing intrauterine systems 20 mg/24h (Mirena (R)). A total of 211 subjects had data that were valid for analysis: 12 women out of 223 (5,4%) were excluded from the prospective study lost to follow-up. A venous blood sample for serum ferritin (mg/l), iron (mg/dl), hemoglobin (g/dl), hematocrit (%), blood cell count, MCHC and MCV was taken during follow-up. RESULTS: PRG or LNg-IUSs determined a significant reduction in menstrual blood loss and in irregular bleeding by gradually reducing endometrial fitness and vascularisation. Serum ferritin significantly increased in women inserted with LNg- IUSs already after 6 months (26+/-22 e 28+/-14 microgram/l versus 32.5+/-19 e 34.5+/-25 microgram/l). Hemoglobin significantly increased (p>0.05) 6 months after insertion. On the contrary this did not occur with the insertion of Cu-IUDs. We observed that the increased amount of copper, released by IUD, causes increasing of bleeding. CONCLUSIONS: The LNg-IUS is a new contraceptive method combining the advantages of both hormonal and intrauterine contraception. In addition, it can be considered an alternative method in the treatment of menorrhagia and dysfunctional uterine bleeding. On the contrary, in women inserted with Cu-IUDs, the main reason of menorrhagia probably is due both to the shape of device and to copper surface area.     

活性γ型IUD(记忆合金)与TCu380AIUD的多中心随机对照临床研究

目的:观察活性γ-IUD(记忆合金)的妊娠率、脱落率、因症取出率和续用率、副作用及对生活质量的影响。方法:采用多中心随机对照的研究方法,对活性γ-IUD(记忆合金)与TCu380AIUD作临床效果比较。按常规要求放置IUD,在置器后的第3、6、12个月进行随访,观察临床效果和副作用。结果:共接纳对象1 987例,活性γ组993例,T-IUD组994例,对象的临床特征组间基本相似。置器后12个月的随访率活性γ组和T-IUD组分别为87.0%和86.6%;置器1年净累积续用率活性γ-IUD组为93.40%,T-IUD组为88.67%(P<0.01)。置器1年时粗累积脱落率活性γ-IUD组和T-IUD组分别为每100妇女年1.57和1.91(P>0.05),带器妊娠率分别为每100妇女年0.68和0.12(P<0.01);因IUD下移停用率分别为每100妇女年1.88和4.20(P<0.01);因出血停用率分别为每100妇女年1.13和4.10(P<0.01);因疼痛而停用、因症取出及非因症取出率组间相似。置器后各阶段副反应主诉的发生率活性γ-IUD组均明显低于T-IUD组(P<0.05)。生活质量均得到改善。结论:活性γ-IUD(记忆合金)比TCu380AIUD续用率高,下移和出血副反应少,是一种临床效果较好、副反应发生率较低的新型IUD。     

左炔诺孕酮宫内缓释系统用于防治子宫内膜异位症和子宫腺肌病的临床观察

目的观察左炔诺孕酮宫内缓释系统(LNG-IUS)用于治疗子宫内膜异位症(EM)及子宫腺肌病(AM)相关疼痛和防止复发的疗效。方法EM患者21例,AM患者12例,于保守性手术后即刻,或单纯疼痛复发后放置LNG-IUS,EM患者中有4例在放置前注射促性腺激素释放激素激动剂(GnRHa),AM患者中有5例放置前注射GnRHa。以放置LNG-IUS前后自身对照,比较疼痛视觉模拟评分(VAS)、血清生殖激素和CA125水平,随诊记录阴道出血等副反应的发生情况;放置前注射GnRHa者与单纯放置者比较出血模式的差异。结果疼痛复发后单纯放置LNG-IUS的5例EM患者,VAS评分由放置前的(8·09±0·21)降至(1·64±1·12)分,两者比较,差异有统计学意义(P=0·042);5例单纯放置LNG-IUS的AM患者,VAS评分由(8·41±1·59)降至(3·99±3·87)分,两者比较,差异无统计学意义(P=0·068)。所有患者于随访期限内,仅2例患者分别出现疼痛或病灶复发,其余患者无疼痛或病灶的复发。放置LNG-IUS后有30例患者完成了初次随诊,初次随诊时间平均为5个月,月平均出血天数18·6d,以不规则点滴出血为主;放置LNG-IUS前是否加用GnRHa的患者月平均出血天数分别为(19±6)和(18±6)d,两者比较,差异无统计学意义(P=0·089)。随诊满1年时,22例患者转为每月规律性阴道出血,月平均出血天数8d。结论LNG-IUS能有效控制EM和AM相关疼痛并延缓复发,不规则和(或)点滴阴道出血是最显著的副反应,放置前注射GnRHa对出血的改善效果欠佳。     

Prospective comparison study of levonorgestrel IUD versus Roller-Ball endometrial ablation in the management of refractory recurrent hypermenorrhea

OBJECTIVE: To compare endometrial ablation and levonorgestrel-IUS for treatment of refractory reccurrent hypermenorrhea. STUDY DESIGN: 30 patients with refractory recurrent hypermenorrhea were included in a prospective controlled comparative study. A transcervical Roller-Ball ablation was carried out in 15 patients after a 2-months GnRH analog pretreatment. A levonorgestrel IUD (MIRENA(R), Schering AG Berlin, Germany) was inserted in 15 patients for the treatment of hypermenorrhea. In a follow-up of the bleeding behavior over 12-24 months a reduction of bleeding was achieved in 14 of 15 patients after Roller-Ball ablation and in 11 of 15 patients after levonorgestrel IUD insertion. The amenorrhea rates are roughly the same in both groups. Side effects of levonorgestrel IUS were rare and mostly temporary. CONCLUSIONS: The insertion of a levonorgestrel IUD for the local hormonal treatment of recurrent hypermenorrhea refractory to oral treatment can be tried before endometrial ablation. The MIRENA(R) device is particularly advantageous for younger patients who might wish to have more children. The levonorgestrel IUD treatment can replace approx. 75% of endometrial ablations.     

Comparative study of Lippes Loop and CuT inserted in immediate post-abortal period

300 cases were selected from Medical Termination of Pregnancy Clinic of Eden Hospital, Medical College, Calcutta, India in order to establish the safety and efficacy of immediate post-abortal insertion of 2 different types of IUDs - the Lippes loop and Cu T. The objective of the investigation was to compare 3 groups of cases in immediate post-abortal period, regarding ease of insertion, insertional bleeding, post-menstrual disturbance, continuation of device, and incidence of pregnancy. The cases were grouped as follows: 1) group A - 100 cases in which no IUD was inserted; 2) group B - 100 immediate post-abortal cases where a Lippes loop (27.5 mm size) was inserted; and 3) group C - 100 immediate post-abortal cases where CuT 200 was inserted. Subsequently, the number of cases having bleeding decreased in group A, where IUDs were not inserted. Between groups B and C duration of bleeding markedly decreased in group C. At 7 days and 1 month after discharge, bleeding varied from light to heavy where Lippes loops were inserted. Cu T has a noticeable improvement in this aspect, but there was some incidence of bleeding varying from light to moderate in comparison to Group A. The incidence of abdominal pain in follow-up cases in group B was more at both 7 days and 1 month following the insertion than in groups C and A. There was a definite increase in leucorrhea and pelvic pain in group B in comparison to groups C and A. In group B there was early onset of menstruation in comparison to groups A and C. There was hardly any difference between groups A and C regarding onset of menstruation. There was an increase in incidence of removal of the device in group B in comparison to group C. There was 1 incidence of expulsion and pregnancy in group C; the expulsion rate was 7% and the pregnancy rate was 1% in group B.     

Local proteinase inhibitor concentration in uterine secretions with intrauterine spirals (IUD) in situ (proceedings)

A study to determine the etiology of bleeding in women who use IUDs is reported. Alpha 1 - anttrypsin (AT) and alpha 1x antichymotrypsin (ACT) levels in serum samples and endometrial secretions were measured in 30 women before and after IUD insertion. The ACT level remained unchanged after IUD insertion. AT in the serum remained unchanged, but the levels in the endometrial secretions sank to a low point 2 months after insertion but rose to levels slightly above insertion levels after 6 months. The local application of proteinase inhibitors could therefore be used to treat bleeding which occurs after IUD insertions.     

多囊卵巢综合征患者外周血Ang-(1-7)、AngⅡ/Ang-(1-7)比值与胰岛素抵抗及脂代谢的相关性研究

目的探讨多囊卵巢综合征(PCOS)患者中肾素血管紧张素系统(renin angiotensin system,RAS)与胰岛素抵抗(IR)及脂代谢的关系。方法 PCOS患者根据胰岛素抵抗指数(HOMA-IR)分为IR组(HOMA-IR≥2.69,n=80)与非IR组(NIR组,HOMA-IR2.69,n=67),另以25例正常月经周期女性作为对照组。采用酶联免疫法(ELISA)测定外周血血管紧张素Ⅱ(AngⅡ)、血管紧张素1-7[Ang-(1-7)]的水平,化学发光法测定血清性激素、空腹胰岛素(FINS)、血脂水平。结果 (1)IR组与NIR组外周血中AngⅡ和Ang-(1-7)水平均高于对照组(P0.05),IR组与NIR组间AngⅡ水平无统计学差异(P0.05),但Ang-(1-7)水平IR组低于NIR组(P0.05);(2)IR组外周血中AngⅡ/Ang-(1-7)比值高于NIR组及对照组(P0.05),NIR组AngⅡ/Ang-(1-7)比值较对照组无统计学差异(P0.05);(3)Pearson相关分析显示,IR组外周血中Ang-(1-7)与FINS、HOMA-IR、体质量指数(BMI)呈负相关,与卵泡刺激素(FSH)呈正相关(P0.05);NIR组外周血中Ang-(1-7)与甘油三酯(TG)呈负相关,与高密度脂蛋白(HDL)呈正相关(P0.05)。结论 PCOS患者外周血存在AngⅡ、Ang-(1-7)亢进现象;AngⅡ/Ang-(1-7)比值失衡与PCOS患者的IR及代谢紊乱有关,Ang-(1-7)水平的提高可能改善IR及代谢紊乱。