首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (4): 514-519.doi: 10.3969/j.issn.1006-7795.2020.04.003

• 绝经与生殖内分泌 • 上一篇    下一篇

奥利司他综合干预对超重或肥胖型多囊卵巢综合征患者代谢综合征及其组分的影响

闵敏1, 阮祥燕1,2, 王虎生1, 程姣姣1, 罗穗豫1, 许仲婷1, 李萌1, Alfred O. Mueck1,2   

  1. 1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
    2. 德国图宾根大学妇产医院妇女健康部与妇女健康研究中心, 图宾根D-72076, 德国
  • 收稿日期:2020-05-08 出版日期:2020-08-21 发布日期:2020-07-22
  • 通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
  • 基金资助:
    北京市医院管理局"登峰"计划专项经费(DFL20181401),中国国际人才交流促进会医疗健康技术创新与人才培养专项基金(2017041900004,2018042000001)。

Effects of orlistat comprehensive intervention on metabolic syndrome and its components in overweight or obese polycystic ovarian syndrome patients

Min Min1, Ruan Xiangyan1,2, Wang Husheng1, Cheng Jiaojiao1, Luo Suiyu1, Xu Zhongting1, Li Meng1, Alfred O. Mueck1,2   

  1. 1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
    2. Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tubingen, Tubingen D-72076, Germany
  • Received:2020-05-08 Online:2020-08-21 Published:2020-07-22
  • Supported by:
    This study was supported by Beijing Municipal Administration of Hospitals'Ascent Plan(DFL20181401),China International Talent Exchange Association Medical Health Technology Innovation and Talent Training Special Fund(2017041900004,2018042000001).

摘要: 目的 探讨奥利司他综合干预对合并代谢综合征(metabolic syndrome,MS)的超重或肥胖型多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者的MS组分及治疗有效率等的影响。方法 选取2018年5月至2019年7月于首都医科大学附属北京妇产医院内分泌科就诊的62例合并MS的超重或肥胖型PCOS患者为研究对象,采用抽签法随机分为两组,单用屈螺酮炔雌醇片(Ⅱ)者作为对照组(n=18),奥利司他联合屈螺酮炔雌醇片(Ⅱ)者为观察组(n=44),观察不同方案治疗前后两组患者MS组分,体质量,性激素,肝、肾功能及MS治疗有效率等指标变化。结果 治疗3个月后,两组的体质量、腰围、臀围、体质量指数(body mass index,BMI)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)、总睾酮(total testosterone,TT)、游离睾酮(free testosterone,FT)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)均明显下降,性激素结合球蛋白(sex hormone-binding globulin,SHBG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)明显升高。观察组体质量、BMI、LDL-C及空腹血糖(fasting plasma glucose,FPG)下降的程度大于对照组,差异有统计学意义(P<0.05)。治疗后两组MS治疗有效率比较,差异无统计学意义(P>0.05)。结论 奥利司他联合屈螺酮炔雌醇片(Ⅱ)治疗在减轻体质量、改善脂代谢异常、降血糖等方面优于单用屈螺酮炔雌醇片(Ⅱ),为临床药物治疗方案的选择提供了依据。

关键词: 超重或肥胖, 多囊卵巢综合征, 代谢综合征, 奥利司他, 屈螺酮炔雌醇片(Ⅱ)

Abstract: Objective To investigate the effects of orlistat integrated intervention on metabolic syndrome (MS) components and therapeutic efficiency in overweight or obese polycystic ovarian syndrome (PCOS) patients with MS. Methods Totally 62 cases of overweight or obese PCOS patients with MS who visited the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from May 2018 to July 2019 were selected and randomly divided into two groups,using drospirenone and ethinylestradiol tablets(Ⅱ) alone as the control group (n=18), orlistat plus drospirenone and ethinylestradiol tablets(Ⅱ) as the observation group (n=44).The changes of MS components, body mass, sex hormones, liver and kidney function and MS therapeutic efficiency were observed before and after different regimens. Results After 3 months of treatment, body weight, waist circumference, hip circumference, body mass index (BMI), luteinizing hormone(LH), estradiol(E2), total testosterone(TT), free testosterone (FT) and low density lipoprotein-cholesterol(LDL-C) of both two groups decreased significantly, while sex hormone-binding globulin(SHBG) and high density lipoprotein-cholesterol (HDL-C) increased significantly (P<0.05). Body weight, BMI, LDL-C and fasting plasma glucose (FPG) decreased more in the observation group than in control group (P<0.05). There was no significant difference in therapeutic efficiency of MS between the two groups after treatment. Conclusion Combinatorial treatment of orlistat with drospirenone and ethinylestradiol tablets(Ⅱ) is better than drospirenone and ethinylestradiol tablets(Ⅱ) alone in reducing body weight, improving abnormal lipid metabolism, lowering blood glucose and other aspects, which provides a basis for the selection of clinical drug treatment plan.

Key words: overweight or obese, polycystic ovary syndrome, metabolic syndrome, orlistat, drospirenone and ethinylestradioltablets(Ⅱ)

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