摘要
目的 探究司美格鲁肽联合二甲双胍治疗多囊卵巢综合征伴胰岛素抵抗(PCOS-IR)的疗效。方法 按照治疗方法的不同将2022年6月至2024年5月于浙江省绍兴市上虞人民医院接受治疗的120例PCOS-IR患者分为对照组(二甲双胍治疗)与观察组(司美格鲁肽联合二甲双胍)。比较2组疗效、体质量指数(BMI)、腰臀比、月经周期、糖脂代谢指标[胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)]、性激素[卵泡刺激素(FSH)、睾酮(T)、黄体生成素(LH)、LH/FSH]、沉默信息调节因子1(SIRT1)/腺苷酸活化蛋白激酶(AMPK)信号通路表达及不良反应。结果 观察组总有效率(91.7%)较对照组(78.3%)高(P<0.05)。治疗后,观察组BMI(21.24±2.48)kg/m^(2)、腰臀比(0.73±0.12)、月经周期(31.19±6.85)d较对照组[(23.31±2.52)kg/m^(2)、(0.78±0.13)、(36.23±7.59)d]低(P<0.05)。治疗后,观察组TG(1.2±0.3)mmol/L、TC(4.3±0.6)mmol/L、HOMA-IR(2.9±0.8)及LH(8.43±2.51)U/L、LH/FSH(1.30±0.26)、T(2.08±0.36)nmol/L较对照组[(1.5±0.4)mmol/L、(4.7±0.6)mmol/L、(3.4±0.6)、(11.18±2.25)U/L、(1.74±0.29)、(2.47±0.42)nmol/L]低,SIRT1(0.92±0.13)、AMPK(0.76±0.11)表达量较对照组[(0.84±0.14)、(0.71±0.09)]高(P<0.05)。2组不良反应比较,差异无统计学意义(P>0.05)。结论 司美格鲁肽联合二甲双胍治疗PCOS-IR可提高疗效,降低体质量,促进月经周期恢复,且可改善糖脂代谢指标及性激素水平,调节SIRT1/AMPK信号通路,安全可靠。
Objective To explore the efficacy of semaglutide combined with metformin in the treatment of polycystic ovary syndrome with insulin resistance(PCOS-IR).Methods A total of 120 PCOS-IR patients treated in Shangyu People′s Hospital of Shaoxing City from June 2022 to May 2024 were divided into a control group(treated with metformin)and an observation group(treated with semaglutide combined with metformin)by different treatment methods,with 60 cases in each group.The therapeutic efficacy,body mass index(BMI),waist-to-hip ra-tio,menstrual cycle,glycolipid metabolism indicators[insulin resistance index(HOMA-IR),triglyceride(TG),total cholesterol(TC)],sex hormones[follicle-stimulating hormone(FSH),testosterone(T),luteinizing hormone(LH),LH/FSH ratio],expression of silent information regulator 1(SIRT1)/adenosine monophosphate-activated protein kinase(AMPK)signaling pathway,and adverse reactions were compared between the two groups.Results The total ef-fective rate of the observation group was 91.7%,which was higher than 78.3%of the control group(P<0.05).After treatment,the BMI(21.24±2.48)kg/m^(2),waist-to-hip ratio(0.73±0.12),and menstrual cycle(31.19±6.85)days in the observation group were lower than those in the control group[(23.31±2.52)kg/m^(2),(0.78±0.13),(36.23±7.59)days](P<0.05).After treatment,the levels of TG(1.2±0.3)mmol/L,TC(4.3±0.6)mmol/L,HOMA-IR(2.9±0.8),LH(8.43±2.51)U/L,LH/FSH ratio(1.30±0.26),and T(2.08±0.36)nmol/L in the observation group were lower than those in the control group[(1.5±0.4)mmol/L,(4.7±0.6)mmol/L,(3.4±0.6),(11.18±2.25)U/L,(1.74±0.29),(2.47±0.42)nmol/L](P<0.05).The expression levels of SIRT1(0.92±0.13)and AMPK(0.76±0.11)in the observation group were higher than those in the control group [(0.84±0.14), (0.71±0.09)] (P<0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion Semaglutide combined with met-formin in the treatment of PCOS-IR can improve therapeutic efficacy, reduce body weight, promote the recovery of menstrual cycle, improve glycolipid metabolism indicators and sex hormone levels, regulate the SIRT1/AMPK sig-naling pathway, and is safe and reliable.
作者
顾素萍
朱娜君
屠伟平
Gu Suping;Zhu Najun;Tu Weiping(Department of Endocrinology and Metabolic Diseases,Shangyu People′s Hospital of Shaoxing City,Shaoxing,Zhe-jiang 312300,China)
出处
《中国药物与临床》
2025年第17期1132-1137,共6页
Chinese Remedies & Clinics
基金
浙江省医药卫生科技计划项目(2024KY496)。
