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同型半胱氨酸与多囊卵巢综合征和二甲双胍的相关性 被引量：4

The correlation between homocysteine,polycystic ovarian syndrome and metformin
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摘要 目的:探讨空腹血浆总同型半胱氨酸(tHcy)水平与多囊卵巢综合征(PCOS)的关系;分析影响PCOS患者血浆tHcy水平的因素;评估二甲双胍对PCOS患者内分泌及代谢的影响。方法:选择PCOS患者24例并按胰岛素抵抗指数(Ho-ma-IR)将PCOS患者分为胰岛素抵抗(PCOS-IR)组及非胰岛素抵抗(PCOS-NIR)组,24例PCOS患者中16例接受二甲双胍(500 mg,3次/d)治疗,疗程3个月;随机选择同期就诊的月经周期规则、卵巢功能正常的其它因素不孕患者15例为对照。结果:PCOS-IR组血浆tHcy浓度(13.20±3.60)μmol/L显著高于PCOS-NIR组(9.57±2.12)μmol/L(P=0.002),且均显著高于正常对照组(7.31±1.85)μmol/L(均P<0.05);多元逐步回归分析表明Homa-IR是PCOS患者血浆Hcy浓度的独立影响因素;二甲双胍治疗3个月后,PCOS患者高雄激素血症、胰岛素抵抗显著改善,而血浆tHcy水平却显著升高(P=0.001),血清维生素B12(Vit-B12)及叶酸浓度显著降低(P=0.001、P=0.01)。结论:①PCOS患者血浆tHcy水平显著升高可能是其近期不良妊娠结局和远期心血管并发症的重要原因之一。②胰岛素抵抗(IR)是PCOS患者血浆Hcy水平的主要影响因素。③二甲双胍显著改善PCOS内分泌、糖代谢异常的同时,却使血浆tHcy浓度升高,血清Vit-B12、叶酸水平降低。 Objective： To explore the correlation between plasma total homocysteine （tHcy） and polycystic ovarian syndrome （PCOS）, analyze the effect factors of tHcy in patients with PCOS, evaluate the effect of metformin on incretion and metabolism of patients with PCOS. Methods： 24 cases with PCOS were selected and divided into insulin -resistant group （PCOS -IR group） and non -insulin -resistant group （PCOS -NIR group） according to insulin -resistant index （Homa -IR）, 16 cases received metformin （500rag, three times dai- ly） for three months . 15 infertile women with regular menstrual cycle [ （28 ± 2） days] and normal ovaries were selected as control group. Results： The level of plasma they in PCOS - IR group [ （ 13. 20 ±3.60） μmol/L ] was significantly higher than that in PCOS - NIR group [ （9. 57±2. 12） p, mol/L ] （P = 0. 002）, and the levels of plasma tHcy in PC OS -IR group and PCOS -NIR group were significantly higher than that in control group （ both P 〈 0. 05 ） . The multivariate stepwise linear regression analysis indicated that the level of Homa - IR was the independent effect factor of tHcy in patients with PCOS. After three months, hyperandrogenemia and insulin resistance of PCOS patients improved, and plasma tHcy level increased （P = 0. 001 ）, while the levels of vitamin B12 and folic acid decreased （both P 〈 0.05 ） Conelusion： （1）High level of tHcy in patients with PCOS is probably linked to adverse pregnant outcomes and long term cardiovascular complications. （2）lnsulin resistance is the major effect factor of tHcy level in patients with PCOS. （3）Metformin can improve incretion and metabolism of patients with PCOS, increase plasma tHcy level, reduce the levels of vitamin B12 and folic acid.
作者 董丽霞 徐素欣 郝桂敏
机构地区 河北省秦皇岛市妇幼保健院 河北医科大学第二医院生殖医学科
出处 《中国妇幼保健》 CAS 北大核心 2009年第23期3310-3313,共4页 Maternal and Child Health Care of China
关键词 同型半胱氨酸 多囊卵巢综合征 胰岛素抵抗 二甲双胍 Homocysteine Polycystic ovarian syndrome Insulin resistance Metformin
分类号 R711.75 [医药卫生—妇产科学]
  • 相关文献

参考文献12

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二级参考文献20

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共引文献4

同被引文献65

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引证文献4

二级引证文献11

中国妇幼保健
2009年 第23期

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