【摘要】 目的:已有研究证实二手烟与多囊卵巢综合征(PCOS)患者孕产结局相关，然而丈夫戒烟中止PCOS患者二手烟暴露对其孕产结局的具体影响目前尚不清楚。基于一项大型临床试验开展二次分析，研究丈夫戒烟行为对PCOS患者孕产结局的影响。方法:选取2011～2015年参加针刺联合克罗米芬治疗PCOS试验的受试者进行分析。依据其丈夫吸烟情况，将受试者分为不吸烟组387例，戒烟组129例以及吸烟组345例。比较3组一般资料、人体测量学指标、实验室检查结果以及孕产结局并探究丈夫戒烟行为与孕产结局的关系。结果:戒烟组总睾酮水平以及低密度脂蛋白胆固醇水平与不吸烟组相近，均低于吸烟组(P=0.014,P=0.011);3组空腹胰岛素、总胆固醇、载脂蛋白B水平存在显著差异(P=0.029,P=0.018,P=0.024),戒烟组与不吸烟组水平相近，显著低于吸烟组。戒烟组排卵率与不吸烟组接近，显著高于吸烟组(P=0.038)。其他指标差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示，丈夫戒烟行为是PCOS患者排卵的保护因素[OR=1.74,95%CI(1.04～2.92),P=0.035]。结论:丈夫戒烟可改善PCOS不孕患者雄激素代谢以及糖脂代谢，从而显著提高排卵率，临床上应积极鼓励丈夫戒烟以改善孕产结局。更多还原

【Abstract】 Objective: To investigate the effect of spouse smoking cessation(SSC) on the pregnancy outcome of the patients with polycystic ovary syndrome(PCOS) based on a secondary analysis of the results of a large randomized clinical trial. Methods: Based on the inclusion and exclusion criteria, this secondary analysis included 861 female participants in the Trial of Acupuncture Combined with Clomiphene for PCOS from 2011 to 2015. According to the smoking status of their husbands, we divided the subjects into a smoking group(n = 345), a non-smoking group(n =387), and a smoking cessation group(n =129), collected their general demographics, anthropometric indexes, laboratory results and pregnancy outcomes, compared them among the three groups, and analyzed the relationship of SSC with the pregnancy outcomes of the PCOS patients. Results: The levels of total testosterone(T) and low-density lipoprotein cholesterol(LDL-C) in the smoking cessation group were similar to those in the non-smoking group, but significantly lower than those in the smoking group(P= 0.014 and P= 0.011). The contents of fasting insulin, total cholesterol, and apolipoprotein B exhibited statistically significant differences among the three groups(P= 0.029, P= 0.018 and P= 0.024), dramatically lower in the smoking cessation and non-smoking groups than in the smoking group, but similar between the former two. The ovulation rate of the smoking cessation group was similar to that of the non-smoking group, remarkably higher than that of the smoking group(P= 0.038). No statistically significant differences were observed in other indicators among the three groups(P > 0.05). Multivariate logistic regression analysis showed that SSC during pregnancy preparation was a protective factor for ovulation in the PCOS patients(OR = 1.74, 95% CI: 1.04-2.92, P= 0.035). Conclusion: SSC can improve androgen and glucolipid metabolisms of infertile patients with PCOS, and thereby significantly increase the ovulation rate. It is of positive significance to encourage SSC clinically for improving the pregnancy outcomes of infertile women with PCOS.更多还原