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目的探讨炔雌醇环丙孕酮联合胰岛素增敏剂(IS)对多囊卵巢综合征(PCOS)患者内分泌紊乱的干预作用。方法 100例POCS患者随机分为观察组和对照组,各50例,对照组应用炔雌醇环丙孕酮治疗,观察组加用吡格列酮治疗。治疗前后检测两组去氢表雄酮硫酸盐(Ds)、性激素结合蛋白(SHBG)、雄烯二酮(A2)、雌二醇(E2)、睾酮(T)、黄体生成素(LH)、血清促卵泡生成素(FSH)、空腹胰岛素(FIN)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)等指标。结果两组E2、SHBG、Ds、A2、T均较治疗前改善,差异有统计学意义(P<0.05或P<0.01),观察组改善程度优于对照组,差异有统计学意义(P<0.05)。结论炔雌醇环丙孕酮与IS联用治疗PCOS能降低高雄激素血症(HA)、高胰岛素血症(HI)、胰岛素抵抗(IR),改善患者机体的内分泌环境,使卵巢功能得到改善。
Objective To investigate the effects of ethinyl estradiol, cyproterone and insulin sensitizer (IS) on the endocrine disorders in patients with polycystic ovary syndrome (PCOS). Methods 100 patients with POCS were randomly divided into observation group and control group, 50 cases in each group. The control group was treated with ethinylestradiol and progesterone. The observation group was treated with pioglitazone. The levels of dehydroepiandrosterone sulphate (Ds), sex hormone-binding protein (SHBG), androstenedione (A2), estradiol (E2), testosterone (T), luteinizing hormone (LH) (FSH), fasting insulin (FIN), fasting blood glucose (FPG), insulin resistance index (HOMA-IR), insulin secretion index (HOMA-β) and other indicators. Results The levels of E2, SHBG, Ds, A2 and T were improved in both groups before treatment compared with those before treatment (P <0.05 or P <0.01), and the improvement in observation group was better than that in control group (P < 0.05). Conclusions Ethinylestradiol and cyproterone combined with IS can reduce hyperandrogenism (HA), hyperinsulinemia (HI) and insulin resistance (IR), improve the endocrine environment in patients and improve ovarian function .