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目的:探讨多囊卵巢综合征(PCOS)患者体内促甲状腺激素(TSH)对同型半胱氨酸(HCY)水平的影响。方法:选择80例确诊为PCOS的患者为观察组,同期选择月经周期规律、卵巢功能正常的107例育龄期女性为对照组。两组均通过化学发光法测定基础甲状腺功能和叶酸水平,酶联免疫(ELISA)法测定基础血浆同型半胱氨酸水平。结果:两组间叶酸、HCY、TSH水平及胰岛素抵抗指数(HOMA-IR)差异有统计学意义(P<0.01);在PCOS组中,分别以TSH 3.0、3.5、4.0 mIU/L分组进行比较,叶酸、HCY、游离甲状腺素(FT3、FT4)及HOMA-IR差异均无统计学意义(P>0.05);PCOS患者以TSH 3.5 mIU/L为界分组,TSH≥3.5 mIU/L时叶酸水平有降低趋势(P=0.094),HCY有升高趋势(P=0.077);PCOS组中HCY水平的升高与TSH水平无显著相关,与叶酸水平呈显著负相关(r=-0.35,P<0.01)。此外,HCY水平与年龄、体重指数(BMI)、HOMA-IR及TSH水平均无显著相关性(P>0.05)。结论:PCOS患者比正常女性较易发生甲状腺功能低下,应注意补充叶酸,以尽可能预防同型半胱氨酸水平的升高及其升高带来的一系列并发症,在对PCOS的综合治疗中还应注意甲状腺功能的纠正。
Objective: To investigate the effect of TSH on the level of homocysteine (HCY) in patients with polycystic ovary syndrome (PCOS). Methods: Eighty patients diagnosed as PCOS were selected as the observation group, and 107 women of childbearing age who had regular menstrual cycle and normal ovarian function were selected as the control group. The basal thyroid function and folic acid levels were measured by chemiluminescence method. The levels of plasma homocysteine in plasma were determined by enzyme linked immunosorbent assay (ELISA). Results: The levels of folic acid, HCY, TSH and insulin resistance index (HOMA-IR) were significantly different between the two groups (P <0.01). In the PCOS group, TSH 3.0, 3.5 and 4.0 mIU / L were compared , Folic acid, HCY, free thyroxine (FT3, FT4) and HOMA-IR were not significantly different (P> 0.05); PCOS patients with TSH 3.5 mIU / L bounded by the group, TSH ≥ 3.5 mIU / L when folic acid levels (P = 0.094), HCY increased (P = 0.077). There was no significant correlation between HCY level and TSH level in PCOS group (P <0.05) 0.01). In addition, HCY levels did not correlate with age, body mass index (BMI), HOMA-IR and TSH levels (P> 0.05). Conclusions: Patients with PCOS are more likely to have hypothyroidism than normal women. Folic acid should be supplemented to prevent the rise of homocysteine level and its complications as much as possible. In the comprehensive treatment of PCOS Should also pay attention to the correction of thyroid function.