复方醋酸环丙孕酮与二甲双胍干预对改善多囊卵巢综合征内分泌影响

Influence of cyproterone acetate and metformin on endocrine and metabolism in women with polycystic ovary syndrome

目的观察复方醋酸环丙孕酮联合二甲双胍对多囊卵巢综合征(PCOS)患者内分泌及代谢的影响。方法将87例PCOS合并胰岛素抵抗(IR)患者随机分成观察组(47例)和对照组(40例),对照组患者给予复方醋酸环丙孕酮治疗,观察组给予复方醋酸环丙孕酮和二甲双胍联合治疗,观察治疗前后血清生殖激素、血糖、血脂水平变化。结果两组患者经过治疗后黄体生成素(LH)、LH与卵泡刺激素(FSH)比值、睾酮(T)和游离雄激素指数(FAI)均较治疗前明显下降(P<0.05),性激素结合球蛋白(SHBG)明显升高(P<0.05),但组间比较观察组变化更显著(P<0.05)。治疗后患者血清高密度脂蛋白胆固醇(HDL-C)升高(P<0.05),低密度脂蛋白胆固醇(LDL-C)降低(P<0.05),而观察组变化更明显(P<0.05),其他指标治疗前、后无变化(P>0.05)。结论二甲双胍与复方环丙孕酮联合应用治疗PCOS,较单纯应用复方环丙孕酮能更有效改善IR及高雄激素血症,值得临床推广应用。

Objective To observe the influence of cyproterone acetate（CPA） and metformin on endocrine and metabolism in women with polycystic ovary syndrome（PCOS）.Methods A total of 87 women with PCOS were enrolled and randomly allocated into observed group（47 cases） and control group（40 cases）,patients in control group were treated by CPA,while others were treated by CPA and metformin,and the endocrine,metabolism and ovulation were assessed initially and treatment in two groups.Results LH,LH/FSH value,T and FAI significantly reduced（P0.05）,but the SHBG significantly improved（P0.05）,and there was a significant difference between the two groups（P0.05）.After treatment the level of serum HDL-C increased and the level of LDL-C decreased（P0.05）.Conclusion The PCOS patients treated with metformin in combination with CPA may be more effective in improved their endocrine and metabolism than CPA alone.