罗格列酮治疗多囊卵巢综合征对改善内分泌、代谢及排卵功能的疗效

目的　探讨罗格列酮 (Rosiglitazone)对多囊卵巢综合征 (PCOS)合并胰岛素抵抗患者内分泌、代谢及排卵功能的影响。　方法　 2 5例PCOS合并胰岛素抵抗患者于自然月经或撤退性出血第 5天服用罗格列酮 12周 ,观察治疗前后血清生殖激素、胰岛素、血糖、血脂水平及排卵功能的变化。　结果　治疗后 ,患者各时相胰岛素 (INS)水平显著下降 (P <0 .0 1)。高密度脂蛋白胆固醇 (HDL C)显著升高 (P <0 .0 1) ,低密度脂蛋白胆固醇 (LDL C)显著降低 (P <0 .0 5 )。患者血清黄体生成素(LH)、黄体生成素 /促卵泡生成素比值 (LH/FSH)、睾酮 (T)和雄烯二酮 (A)水平均显著下降 (P <0 .0 1) ;性激素结合蛋白 (SHBG)水平显著升高 (P <0 .0 1) ;治疗后克罗米酚促排卵成功率为 72 % ,明显高于治疗前 2 0 % (P <0 .0 1)。　结论　罗格列酮通过改善胰岛素抵抗 ,降低胰岛素水平 ,使PCOS患者异常的血激素、血脂及排卵功能得到明显改善。

Effect of rosiglitazone on reproductive hormones, sugar and lipid metabolism and ovulation in women with polycystic ovary syndrome and insulin resistance

Objective: To evaluate the effect of rosiglitazone on endocrine,metabolism and ovulation in women with polycystic ovary syndrome (PCOS) and insulin resistance.Methods:Twenty-five patients with PCOS plus insulin resistance were treated with rosiglitazone for 12 weeks. Before and after the treatment,serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),estradiol (E2),testosterone (T),androstenedione (A),sex hormone binding globulin (SHBG),insulin and glucose,total cholesterol,triglycerides (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C),apolipoprotein A and apolipoprotein B,as well as ovulation induction were determined.Results: After the treatment,serum levels of insulin decreased significantly (P<0.01);HDL-C increased while LDL-C decreased significantly (P<0.05,P<0.01 respectively);LH,T,A and LH/FSH ratio decreased while SHBG increased significantly (P<0.01). The ovulation rate by clomiphene citrate stimulating therapy was 72% and significantly higher than that before treatment.Conclusion: The reduction of hyperinsulinemia by rosiglitazone may effectively improve the endocrine,metabolism and ovulatory performance in women with PCOS and insulin resistance.