多囊卵巢综合征（痰湿证）患者性激素结合球蛋白水平与糖脂代谢的相关性分析

发布时间：2018-02-04 04:01

本文关键词： 多囊卵巢综合征性激素结合球蛋白糖代谢脂代谢　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过分析痰湿证PCOS患者SHBG水平与糖脂代谢的关系,探讨SHBG在痰湿证PCOS患者中糖脂代谢中的价值,为PCOS的早期诊断和治疗提供依据。方法:基于临床科研信息一体化平台采集的病例数据,选择2014年01月到2016年12月就诊于黑龙江中医药大学附属第一医院妇科门诊的痰湿证PCOS患者251例。记录其病例、临床体征以及实验室相关指标,对其进行SHBG水平与糖脂代谢的相关性分析。用SPSS19.0统计软件进行统计分析。结果:1.临床体征比较:SHBG低值组体重、BMI、溢脂发生率、均高于SHBG正常值组,差异具有统计学意义(P0.05)。两组间的年龄、初潮年龄、收缩压、舒张压、腰围、臀围、WHR、黑棘皮、痤疮均无明显差异,无统计学意义(P0.05)。2.性激素指标比较:SHBG低值组DHEAS、FAI均显著高于SHBG正常值组,差异具有显著统计学意义(P0.01)。SHBG低值组AND高于SHBG正常值组,差异具有统计学意义(P0.05)。两组患者的FSH、LH、LH/FSH、T均无明显差异,差异无统计学意义(P0.05)。3.糖代谢指标比较:SHBG低值组FPG高于SHBG正常值组,差异具有统计学意义(P0.05),FINS、HOMA-IR均明显高于SHBG正常值组,差异具有显著统计学差异(P0.01)。SHBG低值组IGT发生率明显高于SHBG正常值组,差异具有显著统计学差异(P0.01)。两组间T2DM发生率差异无统计学意义(P0.05)。4.脂代谢指标比较:SHBG低值组TG、APOB、APOB/APOA明显高于SHBG正常值组,差异具有显著统计学意义(P0.01),HDL-C、APOA均明显低于SHBG正常值组,差异具有显著统计学意义(P0.01)。两组患者间TC、LDL-C、LPA均无明显差异,差异无统计学意义(P0.05)。5.对PCOS患者进行SHBG和各项指标的相关性分析发现,SHBG与 HDL、APOA 呈正相关,与体重、BMI、DHEAS、AND、FINS、HOMA-IR、FAI、APOB/APOA 呈负相关。结论:1.SHBG与FINS、HOMA-IR呈负相关,低SHBG水平的痰湿证PCOS患者易发生血糖异常。2.SHBG与HDL、APOA呈正相关,与APOB/APOA呈负相关。低SHBG水平的痰湿证PCOS患者易发生血脂异常。3.SHBG与体重、BMI、DHEAS、AND呈负相关,低SHBG水平的痰湿证PCOS患者易发生肥胖和具有更高水平的雄激素。
[Abstract]:Objective: to analyze the relationship between the level of SHBG and the metabolism of glucose and lipid in patients with phlegm dampness syndrome (PCOS) and to explore the value of SHBG in the metabolism of glucose and lipid in patients with phlegm dampness syndrome (PCOS). Methods: case data based on clinical scientific research information integration platform was used to provide the basis for early diagnosis and treatment of PCOS. From January 2014 to December 2016, 251 PCOS patients with phlegm-dampness syndrome were selected from the gynecological outpatient department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. Clinical signs and laboratory indicators. The correlation between SHBG level and glucose and lipid metabolism was analyzed. The results were analyzed by SPSS19.0 statistical software. Results: 1. The clinical signs were compared with the body weight of the low value group. The incidence of lipid spills was higher than that of normal SHBG group (P 0.05). The age, menarche age, systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, black spinous skin of the two groups were significantly higher than those of the control group. There was no significant difference in acne, there was no statistical significance (P 0.05). The sex hormone index was significantly higher in the low value group than in the normal SHBG group. The difference was statistically significant (P 0.01). The AND in the low value group was higher than that in the normal SHBG group, and the difference was statistically significant (P 0.05). There was no significant difference in LH / FSH T and there was no significant difference (P < 0.05). The glucose metabolism index was higher in the low FPG group than in the normal SHBG group. The difference was statistically significant (P 0.05). The HOMA-IR of FINSMA-IR was significantly higher than that of the normal value of SHBG. The incidence of IGT in the low value group of P0.01SHBG was significantly higher than that in the normal value group of SHBG. There was significant statistical difference between the two groups in the incidence of T2DM. There was no significant difference in the incidence of T2DM between the two groups. The APOB/APOA was significantly higher than the normal value of SHBG, and the difference was statistically significant (P 0.01). The APOA of HDL-C0. 01 was significantly lower than that of the normal value of SHBG. The difference was statistically significant (P 0.01). There was no significant difference in LDL-CPA between the two groups. There was no significant difference (P 0.05). The correlation analysis of SHBG and various indexes in patients with PCOS showed that there was a positive correlation between SHBG and HDLAPOA, and a positive correlation between SHBG and body weight. BMI-DHEASA and FINSMA-IRI showed negative correlation with APOB / APOA. Conclusion: 1. SHBG and FINS. There was a negative correlation between HOMA-IR and PCOS with low SHBG level. 2. There was a positive correlation between SHBG and HDLAPOA in patients with low SHBG level of phlegm-dampness syndrome. 2. There was a negative correlation between SHBG and APOB/APOA, and a negative correlation between SHBG and body weight was found in the patients with low SHBG level of phlegm-dampness syndrome PCOS. 3. Low SHBG level of phlegm dampness syndrome PCOS patients are prone to obesity and have a higher level of androgen.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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