二甲双胍联合克罗米芬对多囊卵巢综合征所致不孕症患者胰岛素抵抗指数、激素水平的影响

Effects of Metformin Combined with Clomiphene on Homeostasis Model Assessment for Insulin Resistance and Hormone Levels in Patients with Infertility Induced by Polycystic Ovary Syndrome

目的:探讨二甲双胍联合克罗米芬对多囊卵巢综合征所致不孕症患者胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)、激素水平的影响。方法:选取2016年1月至2017年7月郑州市妇幼保健院收治的多囊卵巢综合征所致不孕症患者80例作为研究对象,以随机数字表法分为观察组和对照组,每组40例。观察组患者给予二甲双胍联合克罗米芬治疗,对照组患者仅给予克罗米芬治疗。比较两组患者HOMA-IR、激素水平[卵泡刺激素(FSH)、空腹胰岛素(FINS)、黄体生成素(LH)、睾酮(T)和雌二醇(E2)]、排卵情况、妊娠情况及妊娠早期流产情况的差异。结果:治疗后,观察组、对照组患者平均HOMA-IR分别为1.44±0.30、2.06±0.36,均明显低于治疗前,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者FSH、FINS、LH及T水平较治疗前明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05);两组患者E2水平的差异无统计学意义(P>0.05)。观察组患者的排卵率、妊娠率明显高于对照组,妊娠早期流产率明显低于对照组,差异均有统计学意义(P<0.05)。结论:二甲双胍联合克罗米芬能显著改善多囊卵巢综合征所致不孕症患者的HOMA-IR和激素水平,促进排卵,提高妊娠率。

OBJECTIVE： To investigate the effects of metformin combined with clomiphene on homeostasis model assessment for insulin resistance（ HOMA-IR） and hormone levels in patients with infertility induced by polycystic ovary syndrome. METHODS： 80 patients with infertility induced by polycystic ovary syndrome admitted into Zhengzhou Maternal and Child Health Hospital from Jan. 2016 to Jul. 2017 were extracted to be divided into observation group and control group via the random number table,with 40 cases in each. The observation group was given metformin combined with clomiphene,while the control group received clomiphene. Differences of HOMA-IR,hormone levels [FSF,FINS,LH,testosterone（ T）and estradiol（ E2） ],ovulation,pregnancy and early pregnancy abortion of two groups were compared. RESULTS： After treatment,the average HOMA-IR of observation group and control group were 1. 44 ± 0. 30 and 2. 06 ± 0. 36,respectively,which were significantly lower than that before treatment,and the observation group was significantly lower than the control group,the difference was statistically significant（ P〈0. 05）. After treatment,the levels of FSH,FINS,LH and T in two groups were significantly lower than those before treatment,and the levels of FSH,FINS,LH and T in observation group were significantly lower than those in control group,and the differences were statistically significant（ P〈0. 05）; there was no significant difference in E2 levels between the two groups（ P〉0. 05）. The ovulation rate and pregnancy rate of the observation group were significantly higher than those of the control group,and the abortion rate of early pregnancy was significantly lower than that of the control group,the differences were statistically significant（ P〈0. 05）. CONCLUSIONS：Metformin combined with clomiphene can significantly improve HOMA-IR and hormone levels in patients with infertility induced by polycystic ovary syndrome,promote the ovulation and improve the pregnancy rate.