罗格列酮和二甲双胍治疗胰岛素抵抗多囊卵巢综合征的临床研究  

The clinical research of rosiglitazone and metoformin in treating the women with polycystic ovary syndrome and insulin resistance.

作　　者：张翠莲[1] 高航云[1] 赵志刚[1] 贾萍[1] 

机构地区：[1]河南省人民医院生殖研究所,郑州450003

出　　处：《中国实用妇科与产科杂志》2004年第8期477-479,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨罗格列酮 (rosiglitazone)和二甲双胍 (metformin)分别对有胰岛素抵抗的多囊卵巢综合征(polycysticovarysyndrome,PCOS)患者促排卵治疗的疗效对比。 方法　选择 2 0 0 2年 2月至 2 0 0 3年 6月存在胰岛素抵抗的PCOS患者 94例 ,将其随机分为A、B、C 3组。A组 36例口服罗格列酮联合克罗米芬治疗 ;B组 30例口服二甲双胍联合克罗米芬 (clomiphenecitrate ,CC)治疗 ;C组 2 8例口服克罗米芬治疗。 3组用药时间均为 3个月经周期。比较 3组用药后的胰岛素抵抗指数 (homainsulin resistance ,HomaIR)变化和排卵的发生情况。结果　A组用药 2个月后HomaIR开始由 1 12± 0 4 9下降为 0 86± 0 4 2 ,用药 3个月HomaIR由 1 12± 0 4 9降为0 6 1± 0 36 ,两者比较差异有显著性意义 (P <0 0 5 ) ;B组用药 2个月后HomaIR无明显下降 ,用药 3个月HomaIR由 1 15± 0 5 2降为 0 83± 0 32 ,两者比较差异有显著性意义 (P <0 0 5 )。C组用药前后HomaIR无变化。治疗后 3个月排卵率A组为 76 9% ,明显优于B组的 6 6 8%和C组的 5 8 8% ,差异有显著性意义 (P <0 0 5 )。结论　罗格列酮比二甲双胍能更快更好地改善PCOS的胰岛素抵抗 ,提高促排卵成功率。Objective To compare the ovulating induction of rosiglitazone(Avandia) and metformin in the treatment of the polycystic ovary syndrome (PCOS) patients with insulin resistance(IR).Methods 94 cases of IR were selected by oral glucose tolerance test(OGTT) and insulin test from the infertile women with PCOS.The 94 cases of IR were divided into three groups:group A(36 cases)received rosiglitazone and clomiphene citrate (CC),group B(30 cases) received metformin and CC,group C(28 cases) received CC only,and all were treated for three menstrual cycle.We compared Homa IR,the insulin level and the ovulation rate,both before and after the treatment.Results After two months of treatment,the Homa IR was significantly decreased from 1 12±0 49 to 0 86±0 42 in group A (P<0 05),but there was no significant decrease in group B and C.After three months of treatment,the Homa IR was significantly decreased from 1 12±0 49 to 0 61±0 36 and 1 15±0 52 to 0 83±0 32 in group A and group B (P<0 05),but there was no significant decrease in group C.The ovulation rate of group A was 76 9% after treatment,which was remarkably higher than those of the group B (66 8%) and C(58 8%) (P<0 05).Conclusion Rosiglitazone can improve the condition of IR more effectively,increasing the success rate of ovulating induction.

关 键 词：罗格列酮 二甲双胍 治疗 胰岛素抵抗 多囊卵巢综合征 促排卵疗法 

分 类 号：R587[医药卫生—内分泌] R711.76[医药卫生—内科学]