罗格列酮联合二甲双胍治疗多囊卵巢综合征促排卵效果

Outcomes of rosiglitazone combined with dimethylbiguanide in promoting ovulation induction in women with polycystic ovary syndrome

目的观察应用二甲双胍、罗格列酮和两者联合治疗对存在胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)患者促排卵的效果。方法选择IR的PCOS患者90例随机分为A、B、C三组,分别口服二甲双胍(28例)、罗格列酮(30例)和罗格列酮联合二甲双胍(32例)。三组用药时间均为3个月,比较用药前后胰岛素抵抗指数(HOMA-IR)和排卵情况。结果 A、B、C组HOMA-IR分别由(3.67±1.06)、(3.63±0.71)(、3.62±0.68)下降为(2.20±0.46)、(2.18±0.44)、(1.81±0.34);C组明显低于A、B两组(P<0.01)。C组治疗后排卵率为84.3%,明显高于A组的35.8%和B组的36.7%(P<0.01)。结论罗格列酮联合二甲双胍能有效改善全身、尤其卵巢局部的IR;在并未应用促排卵药物的情况下,同样能达到相当高的促排卵率。

Objective To investigate the outcomes of rosiglitazone combined with dimethylbiguanide in promoting ovulation induction in polycystic ovary syndrome（PCOS） women with insulin resistance（IR）.Methods Ninety PCOS women with IR were randomly divided into groups of A（28 cases）,B（30 cases） and C（32 cases）,who were treated with dimethylbiguanide,rosiglitazone and rosiglitazone combined with dimethylbiguanide,respectively.The drugs were taken orally for three menstrual cycles.Homeostasis model assessment insulin resistance（HOMA-IR） and ovulation were compared before and after treatment.Results After the treatment,HOMA-IR of groups of A,B and C decreased from （3.67±1.06）,（3.63±0.71） and（3.62±0.68） to（2.20±0.46）,（2.18±0.44） and（1.81±0.34）,respectively（P0.01）,which of group C was lower than that of groups of A and B（P0.01）.Success rate of ovulation after treatment was higher in group C than that in group A or group B（84.3% vs.35.8% or 36.7%）（P0.01）.Conclusion Rosiglitazone combined with dimethylbiguanide can effectively improve IR of general and ovary and promote ovulation induction in PCOS women with IR without any ovulation induction drug.