二甲双胍治疗青少年多囊卵巢综合征的临床研究

Clinical Study of Metformin Therapy for Adolescents with Polycystic Ovary Syndrome

目的观察二甲双胍对青少年多囊卵巢综合征（PCOS）的治疗作用。方法选择30例青少年多囊卵巢综合征患者，年龄15～25岁。二甲双胍850mg／次，2次／d，治疗12周，观察服药前后体重、血压、月经、血睾酮（T）、黄体生成素（LH）、卵泡刺激素（FSH）、LH／FSH的比值、雌二醇（岛）、血脂、空腹厦口服75g葡萄糖后2h血糖（PBG）和胰岛索（INS）的变化。计算体重指数（BMI）和胰岛素敏感指数（ISI）。结果二甲双胍治疗后患者体重指数、胰岛素、睾酮、LH及LH／FSH比值较治疗前下降（P〈0．001），ISI升高（P〈0．001），血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇亦有改善（P〈0．05），治疗前、后患者收缩压均值间差别亦有显著性意义（P〈0．01），73％（22／30）的患者恢复正常月经。结论二甲双胍可改善胰岛素抵抗，降低睾酮、LH及LH／FSH比值，恢复月经，同时改善血压、血糖、血脂，可为PCOS患者尤其是青少年患者提供新的治疗途径。

Objective To access the therapeutic effects of mefformin to adolescents with polycystic ovary syndrome （PCOS）. Methods Thirty patients with PCOS, aged 15 to 25 years, were treated by metformin, 850 mg twice daily for twelve weeks. The changes of the following indexes after administration were observed： body weight, blood pressure, menstruation, testosterone （T）, luteohormone （LH）, follicle stimulating hormone （FSH）, estradiol （E2）, LH/FSH, triglyceride （TG）, total cholesterol （TC）, high density lipoprotein-cholesterol （HDL）, lower density lipoprotein-cholesterol （LDL）, fasting blood glucose （FBG）, 2 h postprandial blood glucose （PBG）, insulin （INS）. The body mass index （BMI） and insulin sensitivity index （ISI） were also calculated. Results After the treatment with metformin, the BMI, the levels of INS, T, LH and LH/FSH ratio were decreased significantly （P 〈 0.001） and ISI was increased significantly （P 〈 0.001）. The levels of FBG, TC, TG, and LDL were also improved （P 〈 0.05 or 0.01）. The average value of diastolic blood pressure was significantly different among groups （P 〈 0.01） and 73.3% of patients （22/30） resumed normal menstruation. Conclusion Metformin can improve insulin resistance, hypefinsulinaemia, decrease the plasma levels of T and LH, and LH/FSH ratio, resume menstrual cycle. At the same time, it also can improve blood pressure, and regulate glucose and lipid.