二甲双胍治疗多囊卵巢综合征孕妇妊娠结局的研究

Study of pregnancy outcomes of pregnant women with polycystic ovary syndrome treated by Metformin

目的比较接受和未接受二甲双胍治疗的多囊卵巢综合征孕妇妊娠结局的差异,以及二甲双胍对胎儿胰岛素水平的影响。方法已经确诊为多囊卵巢综合征并在新疆医科大学第一附属医院产科分娩的产妇,根据孕期接受过(治疗组)或未接受过二甲双胍治疗(对照组)分为2组,比较其妊娠结局的差异,分娩时分别取治疗组和对照组无并发症孕妇的静脉血和胎儿脐静脉血,检测胰岛素水平,比较两组是否存在差异。结果治疗组66例中发生妊娠期糖尿病4例,子痫前期2例,胎儿生长受限2例,羊水过多3例,巨大儿5例。对照组148例中发生妊娠期糖尿病27例,子痫前期21例,胎儿生长受限6例,死胎2例,羊水过多26例,巨大儿28例;两组比较除了胎儿生长受限和死胎外(P> 0.05),其余各项发生率比较均有统计学意义(P <0.05);治疗组和对照组无并发症的孕妇静脉血和胎儿脐静脉血胰岛素水平检测分别为(297±189 pmol/Lvs 351±201pmol/L;P=0.1999),(59±46 pmol/Lvs 77±53 pmol/L;P=0.0923)均无统计学差异。结论多囊卵巢综合征患者孕期服用二甲双胍治疗可有效改善妊娠结局,对胎儿胰岛素水平无影响。

Objective To compare the pregnancy outcomes of pregnant women with polycystic ovary syndrome who treated by metformin and without metformin, to explore effect of metformin on fetal insulin level. Methods The pregnant women who have been diagnosed with polycystic ovary syndrome and childbirth in the first affiliated hospital of Xinjiang medical university were divided into two groups according whether treated by metformin and without metformin, the differences in pregnancy outcomes were compared. The maternal venous blood and fetal umbilical venous blood from the patients but no any obstetric complications were detected by insulin levels,whether there was difference between two groups were compared. Results The treatment group had 66 cases, 4 cases of gestational diabetes and preeclampsia(2 cases), fetal growth restriction in 2 cases, hydramnios in 3 cases, 5 cases of macrosomia. The control group had 148 cases, 27 cases of gestational diabetes and preeclampsia in 21 cases, 6 cases of fetal growth restriction, stillbirth in 2 cases,hydramnios in 26 cases, 28 cases macrosomia, the incidence rate of these complications except still birth and FGR in two groups hadstatistical differences. The insulin levels of maternal venous blood from the patients but no any obstetric complications in two groups(297 ±189 pmol/Lvs351 ±201 pmol/L;P = 0.1999),the insulin levels of fetal umbilical venous blood from the patients but no any obstetric complications in two groups(59±46 pmol/Lvs77±53 pmol/L;P = 0.0923). Conclusion Metformin can improve the pregnancy outcome effectively for the pregnant women with polycystic ovary syndrome and insulin level has no effect on the fetus.