【摘要】：目的探討克羅米芬聯(lián)合二甲雙胍對(duì)多囊卵巢綜合征(PCOS)患者外周血T細(xì)胞亞群及氧化應(yīng)激水平的影響。方法選擇PCOS患者80例,隨機(jī)分為觀察組和對(duì)照組各40例。兩組均口服克羅米芬,觀察組在此基礎(chǔ)上聯(lián)合二甲雙胍,均連續(xù)治療3個(gè)月經(jīng)周期。比較兩組治療前后空腹血糖(GLU)、餐后2 h血糖(2 h PG)、糖化血紅蛋白(Hb A1C)、胰島素抵抗指數(shù)(HOMA-IR),血清谷胱甘肽過(guò)氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、丙二醛(MDA)及晚期氧化蛋白產(chǎn)物(AOPP),CD8~+、CD4~+細(xì)胞百分比及CD8~+/CD4~+。結(jié)果兩組治療后GLU、2 h PG、Hb A1C、HOMA-IR水平均較治療前降低,且觀察組均低于對(duì)照組(P均0.05)。與治療前比較,兩組治療后血清MDA、AOPP水平均降低,血清GSH-PX、SOD水平均升高,且觀察組變化均較對(duì)照組更顯著(P均0.05)。與對(duì)照組治療后及同組治療前比較,觀察組治療后CD4~+細(xì)胞百分比降低、CD8~+細(xì)胞百分比升高、CD4~+/CD8~+降低(P均0.05),對(duì)照組治療前后CD4~+、CD8~+細(xì)胞百分比及CD4~+/CD8~+比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論與單用克羅米芬比較,克羅米芬聯(lián)合二甲雙胍治療PCOS有助于改善患者胰島素抵抗、糾正T細(xì)胞亞群結(jié)構(gòu)失調(diào)、降低氧化應(yīng)激水平。
[Abstract]:Objective to investigate the effects of clomiphene combined with metformin on T cell subsets and oxidative stress in peripheral blood of patients with polycystic ovary syndrome (PCOS). Methods Eighty patients with PCOS were randomly divided into two groups: the observation group (n = 40) and the control group (n = 40). Clomiphene was given orally in both groups, and the observation group combined with metformin for 3 consecutive menstrual cycles. Serum glutathione peroxidase (GSH-PX), insulin resistance index (HOMA-IR) and fasting blood glucose (2 h PG), glycosylated hemoglobin (Hb A1C), insulin resistance index (HOMA-IR) were compared between the two groups before and after treatment. Percentage of superoxide dismutase (SOD) (SOD), malondialdehyde (MDA) and late oxidative protein products (AOPP), CD8~, CD4~) and CD8~ / CD4~. Results after treatment, the levels of GLU,2 h PG,Hb A 1 Con HOMA-IR in the observation group were lower than those in the control group (P 0. 05). Compared with before treatment, the serum MDA,AOPP level decreased and the serum GSH-PX,SOD level increased after treatment in both groups, and the changes in the observation group were more significant than those in the control group (P 0.05). Compared with the control group and the control group before and after treatment, the percentage of CD4~ cells decreased, the percentage of CD8~ cells increased, and the CD4~ / CD8~ ratio decreased after treatment in the observation group, and CD4~ in the control group before and after treatment. There was no significant difference in the percentage of CD8~ cells and CD4~ / CD8~ (P < 0. 05). Conclusion compared with clomiphene alone, clomiphene combined with metformin can improve insulin resistance, correct the disorder of T cell subsets and reduce oxidative stress in patients with PCOS.
【作者單位】： 青海省婦女兒童醫(yī)院;
【分類號(hào)】：R711.75

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1 林金菊，，陳風(fēng)娣;口服克羅米芬致重度卵巢過(guò)度刺激綜合征一例[J];溫州醫(yī)學(xué)院學(xué)報(bào);1998年01期

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