摘要
目的探讨营养干预治疗对肥胖型多囊卵巢综合征(PCOS)患者糖脂代谢的干预作用,以及对患者妊娠的影响。方法采用便利抽样法,选取2017年5月至2019年5月北京市垂杨柳医院妇科诊治并完成随访的98例肥胖型PCOS患者作为研究对象。按照随机数字表法将其分为观察组(n=49)和对照组(n=49),对照组患者实施二甲双胍+达因-35治疗,观察组患者在对照组患者治疗方法基础上实施低碳水化合物和低能量饮食的营养干预治疗。比较两组患者治疗前后体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2h血糖(2hPBG)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)水平的变化情况,并记录两组患者妊娠率及不良反应情况。结果治疗前,两组患者BMI、WHR、FPG、FINS、2hPBG、HOMA-IR、TG、HDL-C、LDL-C、TC、FSH、LH、E2和T指标比较,差异均无统计学意义(均P>0.05);治疗后,两组患者BMI、WHR、FPG、FINS、2hPBG、HOMA-IR、TG、LDL-C、TC、LH、E2和T指标均下降,HDL-C和FSH均升高,差异均具有统计学意义(均P<0.05)。观察组患者较对照组患者指标变化更显著,差异均具有统计学意义(P<0.05)。随访1年后,观察组患者妊娠率(89.80%)明显高于对照组(67.35%),观察组患者不良反应率(18.37%)明显低于对照组(32.65%),差异具有统计学意义(P<0.05)。结论营养干预治疗对肥胖型PCOS患者的治疗是有效的,可以改善PCOS糖脂代谢紊乱,增加受孕概率,并可减少远期并发症的发生。
Objective To investigate the effect of nutritional therapy on glucose and lipid metabolism in obese patients with polycystic ovary syndrome(PCOS)and observe pregnancy.Methods 98 cases of obese PCOS patients admitted to the Beijing Chuiyangliu Hospital from May 2017 to May 2019 were selected by convenient sampling method.According to the random number table method,they were divided into control group(n=49)and observation group(n=49).The control group was treated with metformin+dyne-35.The observation group was treated with low-carbohydrate and low-energy diet on the basis of the treatment methods in the control group.The changes of BMI,WHR,FPG,FINS,2hPBG,HOMA-IR,TG,HDL-C,LDL-C,TC,FSH,LH,E2 and T were compared before and after treatment.The pregnancy rate and adverse reactions of both groups was recorded.Results Before treatment,BMI,WHR,FPG,FINS,2hPBG,HOMA-IR,TG,HDL-C,LDL-C,TC,FSH,LH,E2 and T were not statistically significant(P>0.05);BMI,WHR,FPG,FINS,2hPBG,HOMA-IR,TG,LDL-C,TC,LH,E2 and T were all decreased,LDL-C and FSH were both increased,and the differences were statistically significant(P<0.05).The observation group showed more significant changes than the control group(P<0.05).After 1 year of follow-up,the pregnancy rate of the observation group was 89.80%,which was significantly higher than that of the control group(67.35%).The adverse reaction rate of the observation group was 18.37%,which was significantly lower than that of the control group(32.65%)(P<0.05).Conclusions Nutritional intervention is effective in the treatment of obese PCOS patients,which can improve the disorder of PCOS glycolipid metabolism,increase the probability of conception,and reduce the occurrence of long-term complications.
作者
张晓云
索琦霞
孙京
ZHANG Xiaoyun;SUO Qixia;SUN Jing(Department of Nutriology,Beijing Chuiyangliu Hospital,Beijing 100022,China;Department of Reproduction,Beijing Chuiyangliu Hospital,Beijing 100022,China)
出处
《中国性科学》
2020年第11期67-70,共4页
Chinese Journal of Human Sexuality
关键词
多囊卵巢综合征
肥胖型
营养干预
脂代谢
糖代谢
妊娠率
Polycystic ovary syndrome
Obesity
Nutritional intervention
Lipid metabolism
Glucose metabolism
Pregnancy rate
