罗格列酮联合炔雌醇环丙孕酮治疗多囊卵巢综合征临床疗效观察

目的观察罗格列酮联合炔雌醇环丙孕酮对伴有胰岛素抵抗的多囊卵巢综合征（PCOS）患者的治疗效果。方法选择伴有胰岛素抵抗的PCOS患者68例（试验组）和不伴有胰岛素抵抗的PCOS患者68例（对照组），试验组给予罗格列酮联合炔雌醇环丙孕酮治疗；对照组不给予罗格列酮治疗，其他与试验组相同。检测两组患者治疗前后血清脂联素、瘦素水平，计算治疗前后体质量指数（BMI）、稳态模型评估法胰岛素抵抗指数（HOMA—IR），并观察用药期间不良反应。结果两组治疗前脂联素、瘦素、BMI比较差异均无统计学意义（P〉0．05）；试验组治疗前HOMA-IR明显高于对照组（3．90±0．87比2．15±0．62），差异有统计学意义（P〈0．05）。试验组和对照组治疗后BMI、瘦素均较治疗前明显降低试验组：（25．41±1．01）kg／m2比（30．11±1．51）kg／m2、（0．25±0．08）μg／L比（0．44±0．11）μg／L；对照组：（26．68±1．12）kg／m2比（30．55±1．42）kg／m2、（0．23±0．10）μg／L比（0．39±0．23）μg／L]，脂联素较治疗前明显升高试验组：（1．39±1．10）μg／L比（0．89±0．15）μg／L；对照组：（1．42±1．05）μg/L，L比（0．91±0．44）μg/L]，而且试验组治疗后HOMA-IR（2．09±0．68）较治疗前明显降低，差异均有统计学意义（P〈O．05）；两组治疗后各指标比较差异均无统计学意义（P〉0．05）。试验组治疗过程中未出现明显不良反应。结论炔雌醇环丙孕酮能够改善PCOS患者的代谢紊乱指标，对于伴有胰岛素抵抗的PCOS患者加用罗格列酮治疗，能够有效改善其胰岛素抵抗状态。

Efficacy of rosiglitazone combined with ethinylestradiol cyproterone on treatment of polycystic ovary syndrome

Objective To observe the effect of rosiglitazone combined with ethinylestradiol cyproterone on treatment of polycystic ovary syndrome （PCOS）. Methods Sixty-eight cases with PCOS combined with insulin resistance （experimental group） and 68 cases with PCOS combined without insulin resistance （control group） were selected. The patients in experimental group were given rosiglitazone combined with ethinylestradiol cyproterone, the patients in control group were not given rosiglitazone. The level of seurm adiponectin and leptin was measured before and after treatment in two groups, body mass index （BMI）, Homeostasis model assessment of insulin resistance index （HOMA-IR） was calculated before and after treatment in two groups, and drug adverse reaction was observed. Results There was no significant difference in serum adiponectin, leptin, BMI before treatment between two groups （P 〉 0.05 ）. HOMA-IR in experimental group was higher than that in control group （3.90 ± 0.87 vs. 2.15 ± 0.62）,and there was significant difference （P 〈 0.05）. BMI, leptin after treatment in experimental group and control group was decreased compared with that before treatment experimental group： （25.41 ± 1.01 ） kg/m2 vs. （ 30.11 ± 1.51 ） kg/m2, （0.25 ± 0.08 ） μg/L vs. （0.44 ± 0.11 ） μg/L; control group ： （26.68 ± 1.12） kg/m2 vs. （30.55 ± 1.42） kg/m2, （0.23 ± 0.10） μg/L vs. （0.39 ± 0.23） μg/L],adponectin was increased compared with that before treatment experimental group： （ 1.39 ± 1.10） μg/L vs.（0.89 ± 0.15） μg/L;control group ： （ 1.42 ± 1.05 ） μg/L vs. （0.91 ± 0.44） μg/L ], and HOMA-IR after treatment （2.09 ± 0.68） in experimental group was lower than that before treatment, and there was significant difference （P 〈 0.05）. There was no significant difference between two groups （P 〉 0.05）. Experimental group did not appear obvious drug adverse reaction in the process of treatment. Conclusion Ethinylestradiol cyproterone can improve metabolic disorders indicators, PCOS combined with insulin resistmace should add rosiglitazone to improve insulin resistance.