二甲双胍治疗多囊卵巢综合征的临床效果

Clinical effect of Metformin in the treatment of polycystic ovary syndrome

目的探讨二甲双胍治疗多囊卵巢综合征的临床效果。方法选取2012年1月~2013年8月我院收治的58例多囊卵巢综合征患者作为PCOS组,85例健康女性作为对照组。PCOS组患者给予二甲双胍850 mg治疗,2次/d,共治疗24周,共53例患者完成治疗。比较PCOS组患者与对照组健康女性的血清胰岛素水平、LH、FSH、T、E_2、PRL、PROG、DHEA-S、SHBG水平,比较PCOS组患者治疗前后性激素各指标的变化,监测治疗后月经周期规律及妊娠率情况。结果 PCOS组患者的体重、BMI、FIns、2 h Ins、HOMA-IR、LH、LH/FSH、T高于对照组,SHBG低于对照组,差异有统计学意义(P<0.05),两组患者的其余指标比较,差异无统计学意义(P>0.05)。PCOS组患者治疗后的BMI、LH、LH/FSH、T、FIns、2 h Ins及HOMA-IR水平低于治疗前,SHBG高于治疗前,差异有统计学意义(P<0.05)。治疗前后的FSH、DHEA-S、E_2、PRL、PROG比较,差异无统计学意义(P>0.05)。PCOS组患者治疗前月经周期规律者11例(20.75%),治疗12周后为37例(69.81%),治疗24周后为40例(75.47%),均高于治疗前,差异有统计学意义(P<0.05),妊娠率为46.67%。结论 PCOS患者的性激素水平、月经及生育状况均显著异于健康女性,二甲双胍可有效改善患者性激素水平、调整月经周期紊乱,并明显提高妊娠受孕率,是治疗多囊卵巢综合征较好的选择。

Objective To inbestigate the clinical effect of Metformin in the treatment of polycystic ovary syndrome （PCOS）.Methods From January 2012 to August 2013,58 PCOS patients treated in our hospital were selecteded into PCOS group and 85 healthy women were into control group.The PCOS patients were treated with 850 mg Metformin,twice daily for 24 weeks,53 patients completed the treatment finally.The levels of serum insulin and LH,FSH,T,E2,PRL,PROG, DHEA-S,SHBG were compared between the PCOS group and control group.The changes of indexes mentioned above before and after therapy were compared in PCOS group.The improvement of the menstrual cycle during the treatment and the pregnancy rate after medication by follow-up visits were monitored.Results In the PCOS group,the body weight, BMI,Flns,2 h Ins,HOMA-IR,LH,LH/FSH,and T were higher than those in the control group,and the SHBG level was lower than that in the control group,and the differences were statistically significant （P〈0.05）.The other indicators of the two groups were compared,and the differences were not statistically significant （P〉0.05）.The indexes including BMI,LH, LH/FSH,T, FIns,2 h Ins and HOMA-IR were lower than those before treatment,and SHBG was higher than before treatment,the differences were statistically significant （P〈0.05）.The FSH,DHEA-S,Ez,PRL and PROG before and after treatment were compared,and the differences were not statistically significant （P〉0.05）.In PCOS group,11 patients （20.75%） had regular menstrual cycle before treatment,after 3 months of therapy,the proportion of menstrual regularity was 69.81%,and the proportion of menstrual regularity was 75.47% after the 6 months of treatment,which were all higher than before treatment,the differences were statistically significant （P〈0.05）.Besides,the pregnancy rate was 46.67% in the sixth months after treatment.Conclusion The levels of sex hormones,menstrual and reproductive status in PCOS pa- tients were significantly varied from those of normal women.Metformin could effectively improve the sex hormone level, adjust the menstrual cycle disorder,and improve the pregnancy rate.It is a good choice for the treatment of PCOS.