Therapeutic effect of levothyroxine on ovulation disorder and metabolic abnormality in patients with polycystic ovary syndrome complicated with subclinical hypothyroidism
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摘要: 目的 探讨左旋甲状腺素对多囊卵巢综合征合并亚临床甲减患者排卵障碍和代谢异常的治疗作用。 方法 选择2010年1月—2016年12月台州市第一人民医院多囊卵巢综合征合并亚临床甲减患者200例作为多囊卵巢综合征合并亚临床甲减组和多囊卵巢综合征未合并亚临床甲减患者200例作为多囊卵巢综合征组。多囊卵巢综合征合并亚临床甲减患者中合并胰岛素抵抗者120例,根据随机数字法将其分为甲状腺素组和对照组,每组60例,甲状腺素组给予甲状腺素+二甲双胍治疗,对照组给予二甲双胍治疗。治疗3个月后观察2组代谢指标和排卵率、妊娠率情况。 结果 多囊卵巢综合征合并亚临床甲减组FINS、HOMA-IR、TG、LDL水平均高于多囊卵巢综合征组(P<0.05)。甲状腺素组和对照组治疗后T水平均低于治疗前(P<0.05)。甲状腺素组治疗后TSH水平低于治疗前(P<0.05),甲状腺素组治疗后TSH水平低于对照组治疗后(P<0.05)。甲状腺素组和对照组治疗后FINS、HOMA-IR均低于治疗前(P<0.05)。甲状腺素组治疗后TC和LDL水平均低于治疗前(P<0.05),甲状腺素组治疗后TC和LDL水平低于对照组(P<0.05)。甲状腺素组排卵率和妊娠率均高于对照组,但差异无统计学意义(P>0.05)。 结论 多囊卵巢综合征合并亚临床甲减患者存在血糖血脂代谢异常,左旋甲状腺素治疗可以改善多囊卵巢综合征合并亚临床甲减患者的血糖血脂水平,提高排卵率和妊娠率。Abstract: Objective To investigate the therapeutic effect of L-thyroxine on ovulation disorder and metabolic abnormality in patients with polycystic ovary syndrome complicated with subclinical hypothyroidism. Methods Two hundred cases of polycystic ovary syndrome with subclinical hypothyroidism were selected as the polycystic ovary syndrome with subclinical hypothyroidism group,and 200 cases of polycystic ovary syndrome without subclinical hypothyroidism were selected as the polycystic ovary syndrome group in Taizhou First People's Hospital from January,2010 to December,2016.Polycystic ovary syndrome with subclinical hypothyroidism with insulin resistance patients were 120 cases,were divided into thyroxine group and control group according to random number method,each group was 60 cases.The thyroxine group was given thyroxine + metformin treatment,the control group was given metformin treatment.After 3 months of treatment,the metabolic index and ovulation rate and pregnancy rate were observed. Results The levels of FINS,HOMA-IR,TG and LDL in polycystic ovary syndrome with subclinical hypothyroidism group were higher than those in polycystic ovary syndrome group(P<0.05).The levels of T in the thyroxine group and the control group after treatment were lower than those before treatment(P<0.05).The levels of TSH in the thyroxine group after treatment were lower than those before treatment(P<0.05).The level of TSH after treatment in the thyroxine group was lower than that in the control group(P<0.05).The levels of FINS and HOMA-IR in the thyroxine group and the control group after treatment were lower than those before treatment(P<0.05).The levels of TC and LDL in the thyroxine group after treatment were lower than those before treatment(P<0.05).The levels of TC and LDL after treatment in the thyroxine group were lower than those in the control group(P<0.05).The ovulation rate and pregnancy rate of the thyroxine group were higher than those of the control group,but the difference were not statistically significant(P>0.05). Conclusion The blood glucose and lipid metabolism of polycystic ovary syndrome with subclinical hypothyroidism patients are abnormal.L-thyroxine therapy can improve the blood glucose and lipid levels of polycystic ovary syndrome with subclinical hypothyroidism patients,and improve its ovulation rate and pregnancy rate.
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Key words:
- L-thyroxine /
- Polycystic ovary syndrome /
- Subclinical hypothyroidism
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