二甲双胍对肥胖型多囊卵巢综合征患者糖代谢的影响

Effects of Metformin on Obese Patients with Polycystic Ovary Syndrome glucose Metabolism in the Patients

目的观察二甲双胍对肥胖型多囊卵巢综合征患者糖代谢的影响。方法选取该院妇产科门诊确诊为肥胖型多囊卵巢综合征育龄期妇女65例,于月经或撤血后第5天开始口服二甲双胍,3次/d,餐后半小时,连用3个月,同时辅以控制体重干预治疗。所有病例在用药前后测量身高、体质量,计算体重指数,治疗前及治疗结束后采静脉血检测空腹血糖、胰岛素,并计算胰岛素抵抗指数。由专人记录治疗前后体质量、空腹血糖及胰岛素水平,并计算治疗前后体质量指数及胰岛素抵抗指数。结果 65例肥胖型多囊卵巢综合征患者治疗前体质量为(68.7±13.9)kg,体质量指数为27.7±4.8,治疗后体质量为(65.2±9.6)kg,体质量指数为26.1±4.3,治疗后体质量指数较治疗前下降(P<0.05)。治疗前空腹血糖为(4.9±0.8)mmol/L,治疗后为(4.7±0.6)mmol/L(P>0.05);胰岛素水平治疗前为(16.7±5.3)m IU/L,治疗后为(13.6±3.8)m IU/L,治疗后胰岛素水平较治疗前明显下降(P<0.05);胰岛素抵抗指数治疗前为3.7±0.7,治疗后为2.8±0.2(P<0.05)。结论多囊卵巢综合征患者存在糖代谢异常,二甲双胍有改善胰岛素抵抗的作用,有效减轻体重,是多囊卵巢综合征患者预防糖代谢异常的有效药物。

Objective To observe the effect of metformin on obese patients with polycystic ovary syndrome glucose metabolism in the patients. Methods From June 2012 to December 2014, our hospital obstetrics and Gynecology out-patient diagnosed as obese polycystic ovary syndrome in women of reproductive age in 65 cases, in fifth days after menstruation or withdrawal of blood began to metformin, 3 times one day, half an hour after a meal, for 3 months, at the same time with weight control intervention therapy. In all cases, measurement of height, body mass before and after treatment, calculation of body mass index, before and after treatment in venous blood fasting blood glucose, insulin, insulin resistance index and calculation. By the person record before and after the treatment of body weight, fasting blood glucose and insulin levels before and after treatment, and the calculation of body mass index and insulin resistance index. Results 65 cases of obese patients with polycystic ovary syndrome before treatment, body mass of（68.7±13.9） kg, body mass index was 27.7±4.8, treatment of body mass as（65.2±9.6） kg, body mass index was 26.1＋ 4.3, treatment of body mass index was decreased compared with that before treatment, P〈0.05. Fasting blood glucose was（4.9±0.8） mmol/L, after treatment（4.7±0.6） mmol/L（P〈0.05）; insulin level before treatment for（16.7±5.3） m IU/L, after treatment（13.6±3.8） m IU/L, after treatment with insulin level was significantly lower than that before treatment（P〈0.05）; insulin resistance index before treatment was 3.7±0.7, 2.8±0.2 after treatment（P〈0.05）. Conclusion polycystic ovarian syndrome patients have abnormal glucose metabolism, metformin may improve the role of insulin resistance, effectively reduce weight, is a syndrome patients to prevent the effective drug for abnormal glucose metabolism in polycystic ovary synthesis.