注射用重组人促卵泡激素联合二甲双胍对多囊卵巢综合征患者内分泌指标及子宫内膜容受性的影响

Effects of Recombinant Human Follitropin for Injection Combined with Metformin on Endocrine Indices and Endometrial Receptivity in Patients with Polycystic Ovary Syndrome

目的:探索注射用重组人促卵泡激素联合二甲双胍对多囊卵巢综合征(PCOS)患者内分泌指标及子宫内膜的容受性影响。方法:采用随机数字表法将九江市妇幼保健院2020年8月-2021年8月收治的124例PCOS患者分为对照组和试验组,各62例,对照组进行二甲双胍治疗,试验组采用注射用重组人卵泡刺激素联合二甲双胍治疗。治疗3个月后比较两组临床治疗有效率、生殖内分泌激素[雌二醇(E2)、黄体生成素(LH)、卵泡雌激素(FSH)、睾酮(T)]水平、糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)]水平及子宫内膜受容性[子宫内膜螺旋动脉阻力数值(RI)、搏动数值(PI)、子宫内膜的厚度]。结果:试验组总有效率高于对照组(P<0.05);治疗3个月后试验组生殖内分泌激素水平均低于对照组(P<0.05);治疗3个月后两组FPG、FINS、HOMAIR均低于同组治疗前(P<0.05),且试验组糖代谢指标均低于对照组(P<0.05);治疗3个月后两组RI、PI均低于同组治疗前(P<0.05),且试验组RI、PI均低于对照组(P<0.05);治疗3个月后两组内膜厚度高于同组治疗前(P<0.05),且试验组内膜厚度高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:注射用重组人卵泡刺激素联合二甲双胍能改善POCS患者内分泌水平与子宫内膜容受性,同时缓解胰岛素抵抗状态,安全性良好,具有临床推广应用价值。

Objective:To investigate the effects of Recombinant Human Follitropin for Injection combined with Metformin on endocrine indices and endometrial receptivity in patients with polycystic ovary syndrome(PCOS).Method:A total of 124 patients with PCOS admitted to Jiujiang Maternal and Child Health Hospital from August 2020 to August 2021 were divided into control group and experimental group by random number table method,with 62 cases in each group.The control group was treated by Metformin treatment,the observation group was treated by Recombinant Human Follitropin for Injection combined with Metformin treatment.After 3 months of treatment,the clinical treatment efficiency,reproductive endocrine hormone[estradiol(E2),luteinizing hormone(LH),follicular estrogen(FSH),testosterone(T)]levels and glucose metabolism indexes[fasting blood glucose(FPG),fasting insulin(FINS),homeostasis model insulin resistance index(HOMA-IR)]and endometrial receptivity[endometrial spiral artery resistance index(RI),pulsatile index(PI),endometrial thickness]were compared between two groups.Result:The total effective rate of treatment in experimental group was higher than that in control group,the difference was statistically significant(P<0.05).After 3 months of treatment,the levels of reproductive endocrine hormones in the experimental group were lower than those in the control group(P<0.05).After 3 months of treatment,FPG,FINS,HOMA-IR in the two groups were lower than those before treatment(P<0.05),and the glucose metabolism indexes in the experimental group were lower than those in the control group(P<0.05).After 3 months of treatment,the RI and PI of the two groups were lower than those before treatment(P<0.05),and the RI and PI of the experimental group were lower than those of the control group(P<0.05).After 3 months of treatment,the intimal thickness of the two groups were higher than those before treatment(P<0.05),and the intimal thickness of the experimental group was higher than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Recombinant Human Follitropin for Injection combined with Metformin can improve endocrine level and endometrial receptivity of POCS patients,and alleviate insulin resistance at the same time,with good safety and clinical application value.