二甲双胍治疗多囊卵巢综合征改善生化指标效果观察

Observation on the effect of metformin in the treatment of PCOS to improve biochemical indicators

目的观察二甲双胍治疗多囊卵巢综合征(polycystic ovary syndrome,PCOS)前后性激素、血脂和胰岛素水平变化。方法选择2015~2017年深圳市龙华区人民医院收治的60例PCOS患者,进行二甲双胍治疗,从月经第3 d开始口服,每次500 mg,tid,连用21 d后停药7 d为1个疗程,连用3个疗程。比较患者治疗前后的性激素、血脂和胰岛素抵抗水平。结果治疗后,患者黄体生成素、促卵泡刺激素、血清睾酮、雌二醇、孕酮、抗苗勒氏管激素、游离雄激素指数、总胆固醇、甘油三醇、空腹胰岛素、胰岛素抵抗指数均较治疗前明显下降,性激素结合球蛋白、高密度脂蛋白明显升高,差异均有统计学意义(P<0.05),硫酸脱氢表雄酮、泌乳素、糖化血红蛋白、空腹血糖治疗前后比较,差异无统计学意义(P>0.05)。结论二甲双胍可在一定程度上改善PCOS患者激素水平、血脂水平和胰岛素抵抗。

Objective To observe the changes of sex hormones, blood lipids and insulin levels before and after metformin treatment of polycystic ovary syndrome(PCOS). Methods 60 PCOS patients admitted to People’s Hospital of Longhua District in Shenzhen from 2015 to 2017 were treated with metformin. Oral administration was started from the 3rd day of menstruation, 500 mg each time, tid, and stopped 7 days after continuous use for 21 days as a course of treatment, used 3 courses. The levels of sex hormones, blood lipids and insulin resistance before and after treatment were compared. Results After treated by metformin, LH, FSH, T, E2, P, AMH, FAI TC,TG,FINS, HOMA-IR of patients were significantly lower than before treatment, SHBG and HDL were significantly increased, the differences were statistically significant(P<0.05), DHEA-S, PRL glycosylated hemoglobin and FBG before and after treatment, the difference was not statistically significant(P>0.05). Conclusion Metformin can improve hormone levels, blood lipid levels and insulin resistance in PCOS patients to some extent.