摘要
目的:比较二甲双胍、吡格列酮、卡双平3种药物缓解多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者早期糖代谢异常的情况,探讨临床有效治疗PCOS患者早期糖代谢异常的方案。方法:选取2018年3月至2020年9月在重庆医科大学附属第二医院内分泌代谢病科门诊就诊的150名根据鹿特丹标准诊断为PCOS且同时合并糖代谢异常的患者作为研究对象。按照治疗药物不同分为3组,其中二甲双胍组(A组)50例采用二甲双胍治疗(1 500 mg/d),吡格列酮组(B组)50例采用吡格列酮治疗(30 mg/d);卡双平组(C组)50例采用卡双平治疗(二甲双胍1 000 mg/d,吡格列酮30 mg/d)。观察3组治疗前后3个月空腹及餐后2 h血糖水平、糖化血红蛋白(hemoglobin A1c,HbA1c)、胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)、空腹胰岛素水平,并比较3组临床治疗效果,特别是缓解早期糖代谢异常的情况。结果:吡格列酮组及卡双平组餐后2 h血糖、空腹胰岛素、HOMA-IR治疗前后的改善率、糖代谢异常缓解率均明显高于二甲双胍组(P<0.05)。3组空腹血糖、HbA1c治疗前后的改善率均无统计学意义(P>0.05)。结论:吡格列酮及卡双平较二甲双胍对PCOS患者代谢治疗效果更佳,能够有效降低血糖水平,改善胰岛素抵抗,从而帮助PCOS患者早期糖代谢异常得到缓解,为临床治疗提供理论依据,提高PCOS患者远期生活质量。
Objective:To compare the remission of early abnormal glucose metabolism in patients with polycystic ovary syndrome(PCOS)treated with metformin,pioglitazone and their combination,and to explore the effective clinical treatment of early abnormal glucose metabolism in patients with PCOS.Methods:A total of 150 patients diagnosed with PCOS according to Rotterdam criteria accompanied with abnormal glucose metabolism were enrolled from the Department of Endocrinology and Metabolism of The Second Affiliated Hospital of Chongqing Medical University from March 2018 to September 2020. According to different treatment drugs,they were equally randomized into three groups:group A(50 patients)treated with metformin(1 500 mg/d),group B(50 patients)treated with pioglitazone(30 mg/d)and group C(50 patients)treated with their combination(metformin 1 000 mg/d,pioglitazone 30 mg/d).The levels of fasting and 2 h postprandial blood glucose,hemoglobin A1c(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR),and fasting insulin were observed in the three groups before and after the three-month treatment,and the clinical treatment effects,especially the remission of early abnormal glucose metabolism,were evaluated in the three groups.Results:The improvement rate of 2 h postprandial blood glucose,fasting insulin and HOMA-IR after the treatment,the remission rate of abnormal glucose metabolism in group B and C were significantly higher than those in group A(P<0.05).There were no significant differences in the improvement rate of the fasting blood glucose and HbA1c after the treatment among the three groups(P>0.05).Conclusion:Pioglitazone and their combination have a better therapeutic effect on the metabolism of PCOS patients,which can effectively reduce blood glucose and improve insulin resistance,helping to alleviate the early abnormal glucose metabolism of PCOS patients,providing a theoretical basis for clinical treatment and improving the long-term quality of life of PCOS patients.
作者
刘其聪
刘清
姚火娣
刘东方
Liu Qicong;Liu Qing;Yao Huodi;Liu Dongfang(Endocrinology and Metabolism Department,The Second Affiliated Hospital of Chongqing Medical University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2022年第11期1359-1364,共6页
Journal of Chongqing Medical University
基金
重庆市科委重点资助项目(编号:CQYC2020020331)
重庆市科卫联合重点资助项目(编号:2022ZDXM004)。
关键词
多囊卵巢综合征
糖代谢缓解
二甲双胍
吡格列酮
polycystic ovary syndrome
remission of glucose metabolism
metformin
pioglitazone
