二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗不孕患者疗效观察

Effects of metformin in treatment of infertile patients with polycystic ovary syndrome complicated with insulin resistance

目的探讨二甲双胍（MTF）治疗多囊卵巢综合征（PCOS）合并胰岛素抵抗（IR）不孕患者的效果。方法42例PCOS合并IR不孕患者，其中22例作为试验组，口服MTF，3月未妊娠者加服克罗米芬（CC）3个周期；另20例直接口服CC3个周期作为对照组，观察两组排卵情况、妊娠结局及睾酮（T）、空腹胰岛素（INS）、体重指数（BMI）、血脂等指标的变化。结果试验组有14例（64％）恢复排卵；其中11例（50％）妊娠，均未发生流产，用药3个月后T、INS、BMI均明显降低（P〈0．05），血脂变化不明显（P〉0．05）。对照组有13例（65％）恢复排卵；其中6例（30％）妊娠，均未发生流产；用药3个月后BMI、INS、T、血脂均无明显降低（P〉0．05）。结论应用MTF治疗可提高IR患者的妊娠率及降低T、INS、BMI，且安全、经济、方便。

Objective To study the Effects of metformin（MTF） in treatment of infertile patients with polycystic ovary syndrome （PCOS） complicated with insulin resistance（IR）. Methods Forty -two PCOS with infertility divided into two groups. Study group（n = 22） took mefformin for three months, then took Clomiphene citrate for three cycles if they were not pregnant. Control group （n = 20） were given Clomiphene citrate （CC） for three cycles. The ovulation rate and pregnancy rate and the change of subjects including Testosterone（T） ,fasting insulin （INS）,baric index （BMI） ,blood fat and so on were obserred. Results In study group, 14 patients （64%）resumed ovulation and 11 patients（50% ） got pregnancy, no abortion. The levels of T,INS,BMI were significantly decreased （P 〈 0.05 ） after three months treatment,the level of blood fat had no significantly diference （P 〉0. 05）. In control group, 13 patients （65%）resumed ovulation and 6 patients（30% ） got pregnancy, no abortion. The levels of BMI.INS.T.blood fat have no signifieandy diference （ P 〉 0. 05） after three months treatment. Conclusion Mefformin therapy not only improves pregnant rates but also decreases high T.BMI levels and insulin resistance , and it＇s security, saveing money, convenient.