二甲双胍联合炔雌醇环丙孕酮对多囊卵巢综合征患者性激素水平、胰岛功能、排卵和妊娠影响

Effects of Metformin Combined with Ethinylestradiol and Cyproterone Acetate on Sex Hormone Level,Islets of Langerhans Function,Ovulation and Pregnancy in Patients with Polycystic Ovary Syndrome

目的观察二甲双胍联合炔雌醇环丙孕酮对多囊卵巢综合征(polycystic ovar syndrome,PCOS)患者性激素水平、胰岛功能、排卵和妊娠的影响。方法选取PCOS 106例采用随机数字表法随机将其分为观察组与对照组两组各53例。观察组给予二甲双胍联合炔雌醇环丙孕酮治疗,对照组单用炔雌醇环丙孕酮治疗。观察比较两组治疗前后性激素水平、胰岛功能及治疗后排卵、妊娠、流产情况。结果治疗前,两组性激素及胰岛功能各指标比较差异均无统计学意义(P>0.05)。治疗后,观察组和对照组雌激素(E2)水平较治疗前升高,促卵泡生成素(FSH)、黄体生成素(LH)、睾丸素(T)、空腹血糖(FBG)、胰岛素(FINS)水平及胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMAIR)较治疗前降低,差异均有统计学意义(P<0.05);观察组E_2水平及排卵率、妊娠率高于对照组,FSH、LH、T、FBG、FINS水平及HOMA-β、HOMA-IR、流产率低于对照组,差异均有统计学意义(P<0.05)。结论二甲双胍联合炔雌醇环丙孕酮治疗PCOS相比单用炔雌醇环丙孕酮治疗PCOS临床效果显著,且可调节性激素水平及胰岛功能,能达到升高排卵率及妊娠率、降低流产率的目的。

Objective To observe effects of Metformin combined with Ethinylestradiol and Cyproterone Acetate on sex hormone level,islets of langerhans function,ovulation and pregnancy in patients with polycystic ovar syndrome( PCOS).Methods A total of 106 patients with PCOS were divided into observation group( n = 53) and control group( n = 53) by random number table method. Observation group was treated with Metformin combined with Ethinylestradiol and Cyproterone Acetate,while control group was treated with Ethinylestradiol and Cyproterone Acetate only. Sex hormone levels and islets of langerhans function before and after treatment,and conditions of ovulation,pregnancy and abortion after treatment were observed and compared in two groups. Results There were no significant differences in indexes of serum sex hormone level and islets of langerhans function before treatment between two groups( P > 0. 05). After treatment,estrogen( E2) levels were significantly higher,while follicle stimulating hormone( FSH),luteinizing hormone( LH),testosterone( T),fasting blood glucose( FBG),fasting insulin( FINS),insulin secretion index( HOMA-β) and insulin resistance index( HOMA-IR) levels were significantly lower than those before treatment in two groups( P < 0. 05). In observation group,Serum E2 levels,ovulation and the pregnancy rates were significantly higher,while serum FSH,LH,T,FBG,FINS,HOMA-β and HOMA-IR levels,and abortion rate were significantly lower than those in control group( P < 0. 05). Conclusion Metformin combined with Ethinylestradiol and Cyproterone Acetate in the treatment of patients with PCOS is more effective than that by Ethinylestradiol and Cyproterone Acetate only,and it may also regulate sex hormone level and islets of langerhans function,and increases ovulation and pregnancy rates and decreases abortion rate.