摘要
目的:探讨比较单独应用达英-35以及达英-35分别与二甲双胍、罗格列酮联合治疗多囊卵巢综合征(PCOS)伴有胰岛素抵抗(IR)不孕患者效果及促排卵结局的差异。方法:97例PCOS伴有IR不孕患者随机分成3组,A组(单独应用达英-35)35例,B组(达英-35和二甲双胍)32例,C组(达英-35和罗格列酮)30例,3组患者治疗3个周期后均促排卵。比较用药后对体重、WHR、BMI、糖代谢、性激素及促排卵结局的影响。结果:3组患者治疗后血清睾酮较治疗前明显降低,B组、C组患者空腹胰岛素,胰岛素抵抗指数等显著下降;治疗后B组、C组妊娠率较A组增高,周期取消率、OHSS发生率较A组降低,差异均有统计学意义。结论:PCOS伴有IR不孕患者应用达英-35联合胰岛素增敏剂(二甲双胍及罗格列酮),可以明显改善内分泌、代谢紊乱,在此基础上促排卵,可以明显提高妊娠率。但因罗格列酮的用药安全性问题及价格较贵,所以此类患者应首选二甲双胍治疗。
Objective:To observe the treatment effect of Diane-35 or combined with metfon^n or rosiglitazone in ovulation induction on polycystic ovary syndrome (P COS) women with insulin resistance (IR). Methods:El infertility patients with PCOS arid IR were randomly divided into group A, B and C. 35 patients in group A were given Diane- 35 for 3 months, 32 patients in group B were given metformin and Diane-35 for 3 months. 30 patients in group C were given Diane-35 and Rosiglitazone for 3 months. Then all the patients were given drugs to induction of ovulalion. The weight, waist/hip ratio, body mass index, glycometabolism, sexual hon'none and results of ovulation induction were observed after medication. Results:After 3 months treatment, the serum testosterone level decreased in all of the three groups. The fasting insulin level and index of insulin resistance were significantly decreased in group B and C as compared with those in grope A. Moreover the pregnancy rates were higher in group B and C than in group A, while the rate of ovarian hyerstimulation syndrome (OHSS) and cancellation of the cycle were lower in group B and C than in group A. There was statistical significance between them. Conclusions: Insulin sensitizer-rosiglitazone and metformin combined with Diane-35 used to treat PCOS infertility women with insulin resistance is a quite effective method, which can significant improve endocrine condition, metabolic disorder and induction of ovulation. Metformin is recommended because rosiglitazone is more expensive and its side effects.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2009年第10期618-621,共4页
Journal of Practical Obstetrics and Gynecology