二甲双胍对多囊卵巢综合征不孕患者糖脂代谢指标的影响

Influence of metformin on glycolipid metabolism in patients with polycystic ovarian syndrome

目的探讨二甲双胍治疗对多囊卵巢综合征(PCOS)不孕患者糖脂代谢及性激素指标的影响。方法选取本院2014年3月至2016年3月收治的98例PCOS患者随机分为两组,每组各49例。对照组采用克罗米芬治疗,联合组采用克罗米芬联合二甲双胍治疗。观察两组治疗前后子宫内膜厚度、卵巢体积差异,分析两组治疗前后糖脂代谢指标及性激素水平变化,并对两组治疗后排卵及妊娠情况进行比较。结果治疗后,联合组子宫内膜厚度明显大于对照组,卵巢体积、血清性激素水平则明显小于对照组(P<0.05)。治疗后,联合组患者TC、TG、空腹血糖(FBG)、空腹胰岛素(FIN)以及胰岛素抵抗指数(HOMA-IR)等代谢指标均优于对照组(P<0.05)。治疗后随访1年,联合组排卵率以及1年妊娠率均明显高于对照组(P<0.05)。结论克罗米芬联合二甲双胍可有效改善PCOS患者糖脂代谢和性激素水平,促进排卵,提高临床妊娠率。

Objective To investigate the influence of metformin on glycolipid metabolism and sex hormone in patients with polycystic ovarian syndrome(PCOS).Methods 98 patients with PCOS were randomly divided into two groups,with 49 cases in each group.The control group were treated with clomifene,while the observation group were treated with clomifene combined metformin.The endometrial thickness and ovarian volume were observed in two groups before and after treatment.The changes of glycolipid metabolism and sex hormone indexes in two groups were analyzed before and after treatment.Results The endometrial thickness of observation group was significantly better than control group after treatment,while the sex hormone levels,ovarian volume and antral follicle count(AFC)were lower than control group(P<0.05).The glycolipid metabolism indexes of total cholesterol(TC),triacylglycerol(TG),fasting blood glucose(FBG),fasting insulin(FIN)and homeostasis model assessment-insulin resistance(HOMA-IR)in observation group were significantly better than control group after treatment(P<0.05).The rate of ovulation and pregnancy in observation group was significantly higher than control group after treatment(P<0.05).Conclusions Clomifene combined metformin can significantly improve glycolipid metabolism and sex hormone of patients with PCOS.It is helpful in promoting ovulation and improving clinical pregnancy rate.