综合治疗方案对PCOS不孕患者miR-320、miR-27a及妊娠结局的影响OACSTPCD
Effect of Comprehensive Treatment on MiR-320,MiR-27a and Pregnancy Outcome in Infertile Patients with Polycystic Ovary Syndrome
目的 观察综合治疗方案对多囊卵巢综合征(PCOS)不孕患者生殖激素、微小RNA(miRNA)及预后的影响.方法 以随机数字表法将江门市中心医院 2020 年 7 月至 2022 年 7 月收治的 120 例PCOS不孕患者分为 3 组,每组各 40 例.对照A组采取药物治疗(雌孕激素+克罗米芬+二甲双胍),对照B组采取身心干预(饮食+运动+心理),复合治疗组采取综合治疗方案(药物治疗+身心干预),连续干预 6 个疗程.统计 3 组预后情况及干预前后心理状态[正性负性情绪量表(PANAS)]、miR-320 表达、miR-27a表达、体质量指数(BMI)、抑制素B(IHNB)、臀围、抗苗勒管激素(AMH)、腰围、黄体生成素/卵泡刺激素(LH/FSH).结果 干预 3 个疗程后、6 个疗程后复合治疗组PANAS量表中正性情绪评分>对照B组>对照A组,负性情绪评分<对照B组<对照A组(P<0.05);干预3 个疗程后、6 个疗程后复合治疗组miR-320>对照A组>对照B组,miR-27a、LH/FSH、IHNB、AMH水平<对照A组<对照B组(P<0.05);干预 3 个疗程后、6 个疗程后复合治疗组腰围、BMI、臀围均小于对照A组、对照B组,临床妊娠率 55.00%高于对照A组 32.50%、对照B组 27.50%(P<0.05),而对照A、B组对比差异无统计学意义(P>0.05).结论 综合治疗方案应用于PCOS不孕患者中效果确切,可促进机体激素代谢平衡,调控microRNA表达,减轻肥胖体态、改善月经情况,提升妊娠率,还能改善患者情绪状态.
Objective To observe the effect of comprehensive treatment on reproductive hormones,MicroRNA(miRNA)and prognosis of infertile women with polycystic ovary syndrome(PCOS).Methods A total of 120 infertile PCOS patients admitted to Jiangmen Central Hospital hospital from July 2020 to July 2022 were randomly divided into 3 groups,40 cases in each group.The control A group took medication(estrogen+clomiphene+metformin),the control B group took physical and mental interventions(diet+exercise+psychology),and the composite treatment group took a comprehensive treatment program(medication+physical and mental interventions),the intervention lasted for 6 consecutive courses.The prognosis of the three groups was statistically analyzed,as well as their psychological status before and after intervention[The Positive and Negative Affect Scale(PANAS)],miR-320 expression,miR-27a expression,body mass index(BMI),inhibin B(IHNB),hip circumference,anti-Mullerian hormone(AMH),waist circumference,luteinizing hormone/follicle stimulating hormone(LH/FSH).Results Comparison of positive emotion scores in the PANAS scale of three groups after three and six courses of intervention:composite treatment group>control group B>control group A;comparison of negative emotion scores:composite treatment group<control group B<control group A(P<0.05);comparison of miR-320 levels among three groups after three and six courses of intervention:composite treatment group>control group A>control group B,comparison of miR-27a,LH/FSH,IHNB,and AMH levels:composite treatment group<control group A<control group B(P<0.05);after 3 and 6 courses of intervention,the waist circumference,BMI,and hip circumference of the combined treatment group were all smaller than those of the control group A and control group B,and the clinical pregnancy rate was 55.00%,which was higher than the 32.50%of the control group A and the 27.50%of the control group B(P<0.05),however,there was no statistically significant difference between the control groups A and B(P>0.05).Conclusion The comprehensive treatment program applied to PCOS infertility patients has a precise effect,which can promote the balance of hormone metabolism,regulate microRNA expression,reduce obesity,improve menstruation,enhance the pregnancy rate,and also improve the patient's emotional state.
何珊;乐爱文;邱杨;甄波;王中海
广东医科大学第一临床医学院,广东 湛江 524000||广东江门中医药职业学院护理学院,广东 江门 529000华中科技大学协和深圳医院妇科,广东 深圳 518000江门市五邑中医院妇科,广东 江门 529099江门市中心医院妇科,广东 江门 529030广东医科大学第一临床医学院,广东 湛江 524000||华中科技大学协和深圳医院妇科,广东 深圳 518000
临床医学
PCOS不孕microRNA激素代谢
PCOSInfertilitymicroRNAHormonesMetabolism
《昆明医科大学学报》 2024 (007)
140-147 / 8
广东省高等职业院校医药卫生类专业教学指导委员会教学改革课题立项项目(2022LX051)
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