来曲唑联合炔雌醇环丙孕酮片对多囊卵巢综合征患者血清性激素及脂质代谢的影响
Effects of letrozole combined with ethinylestradiol and cyproterone acetate tablets on serum sex hormones and lipid metabolism in patients with polycystic ovary syndrome.
作者信息
Lu Kena, Li Na, Zhang Min, Lin Jiajing, Chen Jiaquan
机构信息
Department of Gynecology, The First Affiliated Hospital of Guangxi University of Chinese Medicine Nanning 530023, Guangxi, China.
Department of Paediatrics, Yidu Central Hospital of Weifang Weifang 262500, Shandong, China.
出版信息
Am J Transl Res. 2023 Feb 15;15(2):1271-1280. eCollection 2023.
OBJECTIVE
To investigate the effects of letrozole combined with ethinylestradiol and cyproterone acetate tablets on serum sex hormones and lipid metabolism in patients with polycystic ovary syndrome (PCOS).
METHODS
Clinical data of 152 PCOS patients in the First Affiliated Hospital of Guangxi University of Chinese Medicine from May 2019 to June 2021 were collected for a retrospective analysis. Among the patients, 73 treated with ethinylestradiol and cyproterone acetate tablets alone were seen as control group (CG), and the rest 79 with letrozole combined with ethinylestradiol and cyproterone acetate tablets were seen as observation group (OG). The treatment efficacy was observed, and the adverse reactions in the course of treatment were counted. The levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), estrogen (E), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were compared before and after treatment. The number of mature follicles, ovulation rate and pregnancy rate were assessed. Multivariate logistic regression analysis was used to detect the independent risk factors of ineffective efficacy.
RESULTS
After the treatment, the total efficacy rate of the OG was higher than that of the CG (P<0.05); moreover, the levels of TC, TG, LDL, FSH, LH and T in OG were lower while HDL and E were higher (all P<0.05) than those of the CG. Also, the number of mature follicles, ovulation rate and pregnancy rate were higher in OG than those in the CG (all P<0.05). There was no obvious difference in the incidence of adverse reactions between the groups (P>0.05). Higher fasting glucose, higher Ferriman-Gallway hair score, single drug treatment regimen, higher systolic blood pressure, and lower E before treatment were independent risk factors for ineffective treatment efficacy.
CONCLUSION
Letrozole combined with ethinylestradiol and cyproterone acetate tablets can enhance the treatment efficiency of PCOS and improve serum sex hormones and lipid metabolism in PCOS patients.
目的
探讨来曲唑联合炔雌醇环丙孕酮片对多囊卵巢综合征（PCOS）患者血清性激素及脂质代谢的影响。
方法
收集广西中医药大学第一附属医院2019年5月至2021年6月152例PCOS患者的临床资料进行回顾性分析。其中，73例单纯接受炔雌醇环丙孕酮片治疗的患者作为对照组（CG），其余79例接受来曲唑联合炔雌醇环丙孕酮片治疗的患者作为观察组（OG）。观察治疗效果，统计治疗过程中的不良反应。比较治疗前后黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）、雌激素（E）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平。评估成熟卵泡数量、排卵率和妊娠率。采用多因素logistic回归分析检测治疗效果不佳的独立危险因素。
结果
治疗后，观察组总有效率高于对照组（P<0.05）；此外，观察组的TC、TG、LDL、FSH、LH和T水平低于对照组，而HDL和E水平高于对照组（均P<0.05）。同时，观察组成熟卵泡数量、排卵率和妊娠率均高于对照组（均P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。空腹血糖较高、Ferriman-Gallway毛发评分较高、单药治疗方案、收缩压较高以及治疗前E较低是治疗效果不佳的独立危险因素。
结论
来曲唑联合炔雌醇环丙孕酮片可提高PCOS的治疗效果，改善PCOS患者血清性激素及脂质代谢。
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