经阴道超声介入对胰岛素抵抗PCOS患者的疗效及对内分泌和炎性因子的影响
|
摘要
目的探讨经阴道超声介入治疗胰岛素抵抗的多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的疗效及对其内分泌和炎性因子的影响分析。方法选取暨南大学附属第一医院80例PCOS合并胰岛素抵抗患者,根据治疗方式的不同,分为研究组和对照组(各40例),2组基础药物治疗相同,研究组加用经阴道超声引导下卵泡穿刺治疗,比较2组患者临床疗效等差异。结果研究组治疗后卵泡数、排卵率及妊娠率均高于对照组,中重度OHSS发生率低于对照组(P<0.05);研究组治疗后雌二醇(estradiol,E2)、促黄体素(luteinizing hormone,LH)及睾酮(testosterone,T)水平低于对照组(P<0.05);研究组患者治疗后超敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosisfactorα,TNF-α)、白细胞介素6(interleukin-6,IL-6)水平均低于治疗前(P<0.05)。结论经阴道超声引导下卵泡穿刺治疗PCOS疗效显著优于单纯药物治疗患者,同时可减轻患者的炎性反应,值得临床大力推广。
Objective To investigate the clinical eff icacy of transvaginal ultrasound-guided follicle puncture technique against cases of PCOS with insulin resistance and its inf luence on internal secretion and inf lammatory factors.Methods Eighty cases of patients with PCOS with insulin resistance were selected as subjects, who were equally divided into study group and control group. The two groups were treated with the same basic drugs, but the study group was additionally treated with transvaginal ultrasound guided follicular puncture. Results The clinical efficacy of the study group was better than that of the control group(P<0.05), so were the internal secretion indexes(P<0.05). The inf lammatory factor indexes in the study group improved more significantly after operation(P<0.05). Conclusion The transvaginal ultrasound-guided follicle puncture technique is effective in the treatment of PCOS with insulin resistance, so it is worthy of popularization and application
Objective To investigate the clinical eff icacy of transvaginal ultrasound-guided follicle puncture technique against cases of PCOS with insulin resistance and its inf luence on internal secretion and inf lammatory factors.Methods Eighty cases of patients with PCOS with insulin resistance were selected as subjects, who were equally divided into study group and control group. The two groups were treated with the same basic drugs, but the study group was additionally treated with transvaginal ultrasound guided follicular puncture. Results The clinical efficacy of the study group was better than that of the control group(P<0.05), so were the internal secretion indexes(P<0.05). The inf lammatory factor indexes in the study group improved more significantly after operation(P<0.05). Conclusion The transvaginal ultrasound-guided follicle puncture technique is effective in the treatment of PCOS with insulin resistance, so it is worthy of popularization and application
引文
[1]陈永莲,陈竞茜,钟兰,等.阴道超声卵泡穿刺术对胰岛素抵抗的多囊卵巢综合征免疫功能的影响[J].河北医学,2016,22(2):251-253.
[2]杜彩英,刘利峰.卵泡穿刺术与来曲唑治疗多囊卵巢综合征疗效分析[J].浙江临床医学,2015,17(2):290-291.
[3]池海虹,黄朝霞,程静,等.小卵泡穿刺术在控制性促排卵中应用的效果观察[J].温州医科大学学报,2014,56(9):657-659.
[4]Lin H,Li Y,Li L,et al.Is a GnRH antagonist protocol better in PCOSpatients?A Meta-analysis of RCTs[J].PLoS One,2014,9(3):e91796.
[5]Wa ng R,Li n S,Wa ng Y,et al.Comparisons of GnR Hantagonist protocol versus GnRH agonist long protocol in patients with normal ovarian reserve:a systematic review and meta-analysis[J].PLoS One,2017,24,12(4):e0175985.
[6]Franik S,Kremer JA,Nelen WL,et al.Aromatase ihibitors for subfertile women with polycystic ovary syndrome:summary of a Cochrane review[J].Fertil Steril,2015,103(2):353-355.
[7]Cai J,Liu L,Sun L,et al.Effects of previous ovarian drilling on cumulative ongoing pregnancy rates among patients with polycystic ovarian syndrome undergoing in vitro fertilization[J].Int J Gynaecol Obstet,2016,134(3):272-277.
[8]Mourad S,Brown J,Farquhar C.Interventions for the prevention of OHSS in ART cycles:an overview of Cochrane reviews[J].Cochrane Database Syst Rev,2017,23(1):CD012103.
[9]Seok HH,Song H,Lyu SW,et al.Application of serum antiMullerian hormone levels in selecting patients with polycystic ovary syndrome for in vitro maturation treatment[J].Clin Exp Reprod Med,2016,43(2):126-132.
[10]Al-Inany HG,Youssef MA,Ayeleke RO,et al.Gonadotrophinreleasi ng hor moneant agon ists for assisted reproduct ive technology[J].Cochrane Database Syst Rev,2016,29(4):CD001750.
[11]韩延博.妇科再造胶囊对多囊卵巢综合征患者miRNA-383和miRNA-320表达的影响研究[J].现代医学,2017,45(1):100-102.
[12]刘军,陈琴琴,杨国绘,等.多囊卵巢综合征患者治疗前后血清IL-6、IL-8和TNF-α检测的临床意义[J].放射免疫学杂志,2013,26(6):748-749.
[13]刘晓梅,杜伯涛,苗瑞超,等.炎症因子与多囊卵巢综合征相关性研究进展[J].国际免疫学杂志,2012,35(4):282-285.
[14]龙玲芳.血清镁在多囊卵巢综合征患者中的水平及临床意义[J].标记免疫分析与临床,2017,24(4):401-403.
[15]葛彦,王克华,查玉桃,等.丹栀逍遥丸辅助治疗肝郁化火型多囊卵巢综合征疗效的Meta分析[J].中华中医药学刊,2018,36(1):67-70.
[16]孟丹.疏肝补肾汤联合来曲唑治疗多囊卵巢综合征不孕不育症临床观察及对血清孕酮的影响[J].中华中医药学刊,2018,36(2):507-509.
[2]杜彩英,刘利峰.卵泡穿刺术与来曲唑治疗多囊卵巢综合征疗效分析[J].浙江临床医学,2015,17(2):290-291.
[3]池海虹,黄朝霞,程静,等.小卵泡穿刺术在控制性促排卵中应用的效果观察[J].温州医科大学学报,2014,56(9):657-659.
[4]Lin H,Li Y,Li L,et al.Is a GnRH antagonist protocol better in PCOSpatients?A Meta-analysis of RCTs[J].PLoS One,2014,9(3):e91796.
[5]Wa ng R,Li n S,Wa ng Y,et al.Comparisons of GnR Hantagonist protocol versus GnRH agonist long protocol in patients with normal ovarian reserve:a systematic review and meta-analysis[J].PLoS One,2017,24,12(4):e0175985.
[6]Franik S,Kremer JA,Nelen WL,et al.Aromatase ihibitors for subfertile women with polycystic ovary syndrome:summary of a Cochrane review[J].Fertil Steril,2015,103(2):353-355.
[7]Cai J,Liu L,Sun L,et al.Effects of previous ovarian drilling on cumulative ongoing pregnancy rates among patients with polycystic ovarian syndrome undergoing in vitro fertilization[J].Int J Gynaecol Obstet,2016,134(3):272-277.
[8]Mourad S,Brown J,Farquhar C.Interventions for the prevention of OHSS in ART cycles:an overview of Cochrane reviews[J].Cochrane Database Syst Rev,2017,23(1):CD012103.
[9]Seok HH,Song H,Lyu SW,et al.Application of serum antiMullerian hormone levels in selecting patients with polycystic ovary syndrome for in vitro maturation treatment[J].Clin Exp Reprod Med,2016,43(2):126-132.
[10]Al-Inany HG,Youssef MA,Ayeleke RO,et al.Gonadotrophinreleasi ng hor moneant agon ists for assisted reproduct ive technology[J].Cochrane Database Syst Rev,2016,29(4):CD001750.
[11]韩延博.妇科再造胶囊对多囊卵巢综合征患者miRNA-383和miRNA-320表达的影响研究[J].现代医学,2017,45(1):100-102.
[12]刘军,陈琴琴,杨国绘,等.多囊卵巢综合征患者治疗前后血清IL-6、IL-8和TNF-α检测的临床意义[J].放射免疫学杂志,2013,26(6):748-749.
[13]刘晓梅,杜伯涛,苗瑞超,等.炎症因子与多囊卵巢综合征相关性研究进展[J].国际免疫学杂志,2012,35(4):282-285.
[14]龙玲芳.血清镁在多囊卵巢综合征患者中的水平及临床意义[J].标记免疫分析与临床,2017,24(4):401-403.
[15]葛彦,王克华,查玉桃,等.丹栀逍遥丸辅助治疗肝郁化火型多囊卵巢综合征疗效的Meta分析[J].中华中医药学刊,2018,36(1):67-70.
[16]孟丹.疏肝补肾汤联合来曲唑治疗多囊卵巢综合征不孕不育症临床观察及对血清孕酮的影响[J].中华中医药学刊,2018,36(2):507-509.