【作者】 李红；

【导师】 高芹；

【作者基本信息】 山东大学 ， 妇产科学， 2005， 硕士

【摘要】 目的 探讨多囊卵巢综合征(PCOS)克罗米酚抵抗患者血浆中肿瘤坏死因子—α(TNF-α)的作用及其与克罗米酚抵抗的关系。 方法 选取30例PCOS克罗米酚抵抗患者与26例PCOS非克罗米酚抵抗患者,均采用双抗体夹心ELISA法检测血浆中TNF-α水平,放射免疫法测定血性激素6项,空腹胰岛素(FINS),空腹血浆葡萄糖浓度(FPG)。比较两组间血浆中TNF-α水平、促黄体生成素(LH)、促卵泡生成素(FSH)和胰岛素抵抗程度(HOMA-IR),并进行TNF-α与促黄体生成素/促卵泡生成素、HOMA-IR的相关性分析;PCOS克罗米酚抵抗患者经二甲双胍治疗4-6周后,按有无排卵恢复分为恢复排卵组和未恢复排卵组,两组间对治疗前后血浆中TNF-α水平下降水平及HOMA-IR进行比较。所有计量资料均以(?)±s表示,采用SPSS10.0统计软件分析。 结果 PCOS克罗米酚抵抗组与PCOS非克罗米酚抵抗组间:PCOS克罗米酚抵抗组血浆中TNF-α水平、LH/FSH及HOMA-IR均显著高于PCOS非克罗米酚抵抗组(P<0.05),且TNF-α与HOMA-IR呈显著正相关(r=0.647,P<0.01),与LH/FSH呈显著正相关(r=0.513,P<0.05)。PCOS克罗米酚抵抗组经二甲双胍治疗恢复排卵组与未恢复排卵组:恢复排卵组较未恢复排卵组更多还原

【Abstract】 Objectives To investigate the effect of tumor necrosis factor-α （TNF- α ） and the relationship between TNF—α and clomiphene citrate（CC） resistance in polycystic ovary syndrome（PCOS）.Methods Blood samples were collected from 30 patients with PCOS CC-resistance （A） and another 26 patients without PCOS CC-resistance （B） . Serum TNF-α were determined by ELISA, sexual hormones、 fasting insulin （FINS） and fasting plasma glucose （FPG） were examined by radioimmunoassay. We compared TNF- α、 LH /FSH and HOMA-IR in A and B . A group was separated into ovulation （A₁） and inovulation （A2）. We compared TNF-α and HOMA-IR with A₁ and A₂ , after the treatment of metformin in PCOS CC-resistance for 4-6 weeks.Results The levels of TNF-α and HOMA-IR in PCOS CC resistance group were markedly higher than that in PCOS non-CC resistance group.And there were positive correlation between TNF-α and IR、 LH/FSH in PCOS CC resistance group. The levels of TNF- α and HOMA-IR are markly decrease in patients who ovulated after treament than that in those inovulated in PCOS CCresistance group.Conclusion It was suggested that TNF- a accelerate CC resistance, and there were positive correlation between TNF-a and IR in CC resistance.Metformin can effectively decrease the levels of TNF- a and lighten IR in patients with PCOS CC resistance. To monitor the variation of TNF- a can anticipate the possibility of ovulation in patients,and guide the treatment to CC resistance.更多还原