标题:达英-35联合二甲双胍治疗多囊卵巢综合征对患者性激素、胰岛素抵抗的影响
作者:李砚,王运萍,姚念玲,白璐,赵海波,陈必良,王海旭 空军军医大学西京医院妇产科,陕西 西安 710032
卷次:
2019年30卷17期
【摘要】 目的 探讨达英-35联合二甲双胍治疗多囊卵巢综合征(PCOS)对患者性激素、胰岛素抵抗的影响。方法 选择2017年1月至2018年12月空军军医大学西京医院妇产科收治的168例PCOS患者为研究对象,根据随机数表法将患者分为观察组与对照组,每组84例,对照组患者给予达英-35治疗,观察组在此基础上联合应用二甲双胍治疗,疗程均为3个月。比较两组患者治疗前后的空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)以及性激素水平[促卵泡生成素(FSH)、黄体生成素(LH)、睾酮(T)、泌乳素(PRL)、雌二醇(E2)];随访3个月,比较两组患者的排卵率及妊娠率。结果 治疗后,观察组患者的血清LH、PRL、T水平分别为(8.74±1.24) U/L、(15.50±2.22) pmol/L、(1.98±0.84) nmol/L,明显低于对照组的(9.93±1.27) U/L、(17.46±2.32) pmol/L、(2.25±0.52) nmol/L,E2为(59.49±4.65) pmol/L,明显高于对照组的(53.44±5.34) pmol/L,差异均有统计学意义(P<0.05);治疗后,观察组患者FINS及HOMA-IR水平分别为(14.82±4.47) mU/L、2.27±0.79,明显低于对照组的(22.12±6.24) mU/L、3.46±1.08,差异有统计学意义(P<0.05);随访3个月,观察组患者的排卵率及妊娠率分别为78.57%、51.19%,均明显高于对照组的61.90%、35.71%,差异均有统计学意义 (P<0.05)。结论 达英-35联合二甲双胍应用于多囊卵巢综合征的治疗,与单用达英-35比较,可以改善胰岛素抵抗状态,更加有效地调节性激素水平,提高促排卵效果及妊娠率。
【关键词】 多囊卵巢综合征;胰岛素抵抗;达英-35;二甲双胍;性激素
【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350(2019)17—2203—03
Effect of Diane-35 combined with metformin on sex hormone levels and insulin resistance in patients withpolycystic ovary syndrome.
LI Yan, WANG Yun-ping, YAO Nian-ling, BAI Lu, ZHAO Hai-bo, CHEN Bi-liang, WANGHai-xu. Department of Obstetrics and Gynecology, Xijing Hospital of Air Force Military Medical University, Xi'an 710032,Shaanxi, CHINA
【Abstract】 Objective To investigate the effects of Diane-35 combined with metformin on sex hormones lev-els and insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A total of 168 patients withPCOS were selected as subjects, who were admitted to the Department of Obstetrics and Gynecology at Xijing Hospitalof Air Force Military Medical University from January 2017 to December 2018. According to the random number tablemethod, the patients were divided into observation group and control group, with 84 cases in each group. The controlgroup was treated with Diane-35, and the observation group was additionally treated with metformin on the basis of thecontrol group. Both groups treated for 3 months. The fasting insulin (FINS) levels and insulin resistance index(HOMA-IR) were compared between the two groups before and after treatment, as well as some sex hormones levelsincluding follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), prolactin (PRL), and estradi-ol (E2). After 3 months of follow-up, the ovulation rate and pregnancy rate were compared between the two groups.Results In the observation group, the serum levels of LH, PRL and T after treatment were (8.74±1.24) U/L, (15.50±2.22) pmol/L, (1.98 ± 0.84) nmol/L, respectively, which was significantly lower than corresponding (9.93 ± 1.27) U/L,(17.46±2.32) pmol/L, (2.25±0.52) nmol/L in the control group; and E2 was (59.49±4.65) pmol/L, which was significant-ly higher than (53.44±5.34) pmol/L in the control group (P<0.05). After treatment, the levels of FINS and HOMA-IR inthe observation group was respectively (14.82±4.47) mU/L and 2.27±0.79, which was significantly lower than corre-sponding (22.12±6.24) mU/L and 3.46±1.08 in the control group (P<0.05). After 3 months of follow-up, the ovulationrate (78.57% vs 61.90%) and pregnancy rate (51.05% vs 35.71%) in the observation group were significantly higher thanthose in the control group (P<0.05). Conclusion Diane-35 combined with metformin for the treatment of polycysticovary syndrome, compared with Diane-35 alone, can improve insulin resistance, regulate sex hormone levels more effec-tively, and improve ovulation induction and pregnancy rate.
【Key words】 Polycystic ovary syndrome; Insulin resistance; Diane-35; Metformin; Sex hormone
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