【摘要】 目的 探讨利拉鲁肽联合二甲双胍对肥胖型多囊卵巢综合征(obese polycystic ovary syndrome, OB-PCOS)患者糖脂代谢及生殖功能的影响。方法 选取2018年11月至2020年11月重庆大学附属三峡医院收治的92例OB-PCOS患者，按随机数字表法分成两组，对照组(46例)口服二甲双胍，研究组(46例)在对照组基础上加用利拉鲁肽。比较两组糖脂代谢、氧化应激、生殖功能相关激素指标、建立月经周期率、正常排卵率、自然受孕率、不良反应，并检测血清白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin, PCT)水平。结果 (1)治疗后，两组高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)均高于治疗前，除HDL-C外的其余糖脂代谢指标均低于治疗前，且研究组HDL-C[(1.84±0.61) mmol/L]高于对照组[(1.37±0.45)mmol/L],除HDL-C外的其余糖脂代谢指标均低于对照组，差异均有统计学意义(P<0.05)。(2)治疗后，两组脂质过氧化氢(lipid hydrogen peroxide, LHP)均低于治疗前，谷胱甘肽过氧化物酶(glutathione peroxidase, GSH-Px)均高于治疗前，且研究组LHP低于对照组，GSH-Px高于对照组(P<0.05)。(3)治疗后，两组黄体生成素(luteinizing hormone, LH)、睾酮(testosterone, T)、卵泡刺激素(follicle stimulating hormone, FSH)均低于治疗前，且研究组LH、T、FSH低于对照组(P<0.05)。(4)研究组建立月经周期率(86.96%)、正常排卵率(78.26%)、自然受孕率(41.30%)均高于对照组(69.57%、50.00%、21.74%)(P<0.05)。(5)治疗后，两组血清IL-6、PCT水平均低于治疗前，且研究组血清IL-6、PCT水平低于对照组(P<0.05)。(6)研究组不良反应总发生率(21.28%)与对照组(10.64%)相较，差异无统计学意义(P>0.05)。结论 利拉鲁肽联合二甲双胍治疗OB-PCOS,利于改善糖脂代谢、氧化应激、生殖功能相关激素指标，提高建立月经周期率、正常排卵率、自然受孕率，减轻炎症反应，且安全性尚可。更多还原

【Abstract】 Objective To investigate the effects of liraglutide combined with metformin on glucose and lipid metabolism and reproductive function in patients with obese polycystic ovary syndrome(OB-PCOS).Methods From November 2018 to November 2020,92 OB-PCOS patients admitted to Three Gorges Hospital Affiliated to Chongqing University were selected and divided into two groups according to the random number table method.The control group(46 patients) received oral metformin, and the study group(46 patients) received liraglutide on the basis of the control group.The glucose and lipid metabolism, oxidative stress, reproductive function related hormone indicators, menstrual cycle establishment rate, normal ovulation rate, natural conception rate and adverse reactions were compared between the two groups, and the levels of serum interleukin-6(IL-6),procalcitonin(PCT) were detected.Results(1) After treatment, the high-density lipoprotein cholesterol(HDL-C) of the two groups was higher than before treatment, and the other glucose and lipid metabolism indexes except HDL-C were lower than before treatment, the HDL-C of the study group[(1.84±0.61)mmol/L] was higher than that of the control group[(1.37±0.45)mmol/L], and the other glucose and lipid metabolism indexes except HDL-C were lower than those of the control group, the differences were statistically significant(P<0.05).(2) After treatment, the lipid hydrogen peroxide(LHP) of the two groups were lower than before treatment, and glutathione peroxidase(GSH-Px) was higher than before treatment(P<0.05),the LHP in the study group was lower than that in the control group, and GSH-Px was higher than that in the control group(P<0.05).(3) After treatment, the luteinizing hormone(LH),testosterone(T),and follicle stimulating hormone(FSH) in the two groups were lower than before treatment, and LH,T,FSH in the study group were lower than those in the control group(P<0.05).(4) The menstrual cycle establishment rate in the study group was 86.96%,the normal ovulation rate was 78.26%,and the natural conception rate was 41.30%,they were all higher than those in the control group(69.57%,50.00% and 21.74%)(P<0.05).(5) After treatment, the levels of serum IL-6 and PCT in the two groups were lower than before treatment, and the levels of serum IL-6 and PCT in the study group were lower than those in the control group(P<0.05).(6) The total incidence of adverse reactions in the study group was 21.28% compared with 10.64% in the control group, and the difference was not statistically significant(P>0.05).Conclusion Liraglutide combined with metformin in the treatment of OB-PCOS is beneficial to improve glucose and lipid metabolism, oxidative stress, reproductive function-related hormone indicators, increase the menstrual cycle establishment rate, normal ovulation rate, natural conception rate, and reduce inflammation, and the security is acceptable.更多还原