本文關(guān)鍵詞： 多囊卵巢綜合征 性激素結(jié)合球蛋白 糖代謝 脂代謝　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過分析痰濕證PCOS患者SHBG水平與糖脂代謝的關(guān)系,探討SHBG在痰濕證PCOS患者中糖脂代謝中的價值,為PCOS的早期診斷和治療提供依據(jù)。方法:基于臨床科研信息一體化平臺采集的病例數(shù)據(jù),選擇2014年01月到2016年12月就診于黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院婦科門診的痰濕證PCOS患者251例。記錄其病例、臨床體征以及實驗室相關(guān)指標(biāo),對其進行SHBG水平與糖脂代謝的相關(guān)性分析。用SPSS19.0統(tǒng)計軟件進行統(tǒng)計分析。結(jié)果:1.臨床體征比較:SHBG低值組體重、BMI、溢脂發(fā)生率、均高于SHBG正常值組,差異具有統(tǒng)計學(xué)意義(P0.05)。兩組間的年齡、初潮年齡、收縮壓、舒張壓、腰圍、臀圍、WHR、黑棘皮、痤瘡均無明顯差異,無統(tǒng)計學(xué)意義(P0.05)。2.性激素指標(biāo)比較:SHBG低值組DHEAS、FAI均顯著高于SHBG正常值組,差異具有顯著統(tǒng)計學(xué)意義(P0.01)。SHBG低值組AND高于SHBG正常值組,差異具有統(tǒng)計學(xué)意義(P0.05)。兩組患者的FSH、LH、LH/FSH、T均無明顯差異,差異無統(tǒng)計學(xué)意義(P0.05)。3.糖代謝指標(biāo)比較:SHBG低值組FPG高于SHBG正常值組,差異具有統(tǒng)計學(xué)意義(P0.05),FINS、HOMA-IR均明顯高于SHBG正常值組,差異具有顯著統(tǒng)計學(xué)差異(P0.01)。SHBG低值組IGT發(fā)生率明顯高于SHBG正常值組,差異具有顯著統(tǒng)計學(xué)差異(P0.01)。兩組間T2DM發(fā)生率差異無統(tǒng)計學(xué)意義(P0.05)。4.脂代謝指標(biāo)比較:SHBG低值組TG、APOB、APOB/APOA明顯高于SHBG正常值組,差異具有顯著統(tǒng)計學(xué)意義(P0.01),HDL-C、APOA均明顯低于SHBG正常值組,差異具有顯著統(tǒng)計學(xué)意義(P0.01)。兩組患者間TC、LDL-C、LPA均無明顯差異,差異無統(tǒng)計學(xué)意義(P0.05)。5.對PCOS患者進行SHBG和各項指標(biāo)的相關(guān)性分析發(fā)現(xiàn),SHBG與 HDL、APOA 呈正相關(guān),與體重、BMI、DHEAS、AND、FINS、HOMA-IR、FAI、APOB/APOA 呈負(fù)相關(guān)。結(jié)論:1.SHBG與FINS、HOMA-IR呈負(fù)相關(guān),低SHBG水平的痰濕證PCOS患者易發(fā)生血糖異常。2.SHBG與HDL、APOA呈正相關(guān),與APOB/APOA呈負(fù)相關(guān)。低SHBG水平的痰濕證PCOS患者易發(fā)生血脂異常。3.SHBG與體重、BMI、DHEAS、AND呈負(fù)相關(guān),低SHBG水平的痰濕證PCOS患者易發(fā)生肥胖和具有更高水平的雄激素。
[Abstract]:Objective: to analyze the relationship between the level of SHBG and the metabolism of glucose and lipid in patients with phlegm dampness syndrome (PCOS) and to explore the value of SHBG in the metabolism of glucose and lipid in patients with phlegm dampness syndrome (PCOS). Methods: case data based on clinical scientific research information integration platform was used to provide the basis for early diagnosis and treatment of PCOS. From January 2014 to December 2016, 251 PCOS patients with phlegm-dampness syndrome were selected from the gynecological outpatient department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. Clinical signs and laboratory indicators. The correlation between SHBG level and glucose and lipid metabolism was analyzed. The results were analyzed by SPSS19.0 statistical software. Results: 1. The clinical signs were compared with the body weight of the low value group. The incidence of lipid spills was higher than that of normal SHBG group (P 0.05). The age, menarche age, systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, black spinous skin of the two groups were significantly higher than those of the control group. There was no significant difference in acne, there was no statistical significance (P 0.05). The sex hormone index was significantly higher in the low value group than in the normal SHBG group. The difference was statistically significant (P 0.01). The AND in the low value group was higher than that in the normal SHBG group, and the difference was statistically significant (P 0.05). There was no significant difference in LH / FSH T and there was no significant difference (P < 0.05). The glucose metabolism index was higher in the low FPG group than in the normal SHBG group. The difference was statistically significant (P 0.05). The HOMA-IR of FINSMA-IR was significantly higher than that of the normal value of SHBG. The incidence of IGT in the low value group of P0.01SHBG was significantly higher than that in the normal value group of SHBG. There was significant statistical difference between the two groups in the incidence of T2DM. There was no significant difference in the incidence of T2DM between the two groups. The APOB/APOA was significantly higher than the normal value of SHBG, and the difference was statistically significant (P 0.01). The APOA of HDL-C0. 01 was significantly lower than that of the normal value of SHBG. The difference was statistically significant (P 0.01). There was no significant difference in LDL-CPA between the two groups. There was no significant difference (P 0.05). The correlation analysis of SHBG and various indexes in patients with PCOS showed that there was a positive correlation between SHBG and HDLAPOA, and a positive correlation between SHBG and body weight. BMI-DHEASA and FINSMA-IRI showed negative correlation with APOB / APOA. Conclusion: 1. SHBG and FINS. There was a negative correlation between HOMA-IR and PCOS with low SHBG level. 2. There was a positive correlation between SHBG and HDLAPOA in patients with low SHBG level of phlegm-dampness syndrome. 2. There was a negative correlation between SHBG and APOB/APOA, and a negative correlation between SHBG and body weight was found in the patients with low SHBG level of phlegm-dampness syndrome PCOS. 3. Low SHBG level of phlegm dampness syndrome PCOS patients are prone to obesity and have a higher level of androgen.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R271.9

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