不同胰岛素增敏剂对胰岛素抵抗型PCOS患者的疗效

Comparison of effects of metformin and rosiglitazone on polycystic ovary syndrome with insulin resistance

目的:观察二甲双胍及罗格列酮对多囊卵巢综合征(PCOS)伴有胰岛素抵抗(IR)患者内分泌的影响,评估2种药物对PCOS伴有IR的治疗价值。方法:将38例伴有IR的PCOS患者随机分为两组,一组口服二甲双胍,另一组口服罗格列酮治疗。两组用药时间均为3个月经周期,比较用药前、后体重指数、腰臀比、血清卵泡刺激素(FSH),黄体生成素(LH),睾酮(T)、空腹血糖(FBS)、空腹胰岛素(FIN)、胰岛素抵抗指数(HOMA-IR)的变化以及排卵率、妊娠率的改善情况。结果:罗格列酮比二甲双胍能更好地降低PCOS患者的胰岛素抵抗,但对体质量及腰臀比下降的影响不如二甲双胍。在对性激素的影响及改善排卵率、妊娠率方面两者无显著性差异。结论:二甲双胍、罗格列酮均能改善PCOS患者的胰岛素抵抗状态。二甲双胍有降低体重的作用,价格便宜;罗格列酮减轻胰岛素抵抗效果优于盐酸二甲双胍,且不良反应较小。

Objective： To investigate the effects of metformin and rosiglitazone on the endocrine of patients of polycystic ovary syndrome （PCOS） with insulin resistance （IR） and their clinical value. Methods： Thirty-eight patients of PCOS with IR were randomly divided into two groups （ group A and B）, and treated orally with metformin and rosiglitazone respectively, the course of medication were three menstrual cycles, parameters were compared before and after the treatment, including body mass index, waist-hip ratio, serum follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone （T）, fasting blood glucose （FBS）, fasting insulin （ FIN）, insulin resistance index （ HOMA-IR）, ovulation rate, pregnancy rate. Results： Compared with metformin, rosiglitazone had better effects on the improvement of IR and less effects on the reduction of body mass index and waist-hip ratio; there were no significant differences between the other parameters. Conclusion： Metformin and rosiglitazone can improve insulin resistance of patients with PCOS and IR, of which, rosiglitazone has better effects and less side reactions. Metformin has better effect on the reduction of body weight and is cheaper.