达因-35联合二甲双胍治疗肥胖型PCOS的临床探讨  

Therapy of the Obesity with Polycystic Ovary Syndrome with Diane-35 and Metformin

作　　者：冯玉昆[1] 陆义芹[1] 孙跃平[1] 李白鸾[1] 

机构地区：[1]昆明医学院第一附属医院妇产科,昆明650032

出　　处：《昆明医学院学报》2005年第1期47-50,共4页Journal of Kunming Medical College

摘　　要：目的 :针对多囊卵巢综合征 (PCOS)患者的高雄激素和胰岛素抵抗临床特征 ,用对抗雄激素和胰岛素增敏剂 (达因 - 35加二甲双胍 )进行联合治疗 ,对治疗效果进行评价 .方法 :近 3月未接受激素治疗的PCOS患者 5 0例 ,年龄 18～ 32岁 ,于早卵泡期 (月经 3～ 5d)或闭经期 (B超下无优势卵泡 )采集空腹静脉血 ,测定卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2 )、泌乳素 (PRL)、睾酮 (T) ,以及血清总胆固醇 (Tch)、三酰甘油 (TG)、高密度脂蛋白 (HDL -ch)、低密度脂蛋白 (LDL -ch)、空腹血糖、胰岛素及糖负荷后 6 0min、 12 0min的血糖及胰岛素水平 .其中BMI≥ 2 5肥胖者 ,给予达因 - 35加二甲双胍联合治疗 3月 ,对治疗前后临床特征的改变进行比较和评价 .结果 :达因 - 35与二甲双胍联合运用能有效抑制肥胖PCOS患者雄激素合成 ,促进月经规律 ,为不孕症患者促排卵治疗创造条件 ;能改善胰岛素抵抗状况 ,减轻体重 ,改善脂肪分布 ,减少腰臀围比例 .结论 :(1)肥胖的PCOS患者较非肥胖者有更加严重内分泌失调 ;(2 )对PCOS治疗要针对高雄激素血症 ,同时应重视对胰岛素抵抗的治疗和预防 ,联合性治疗能取得良好效果 .Objective: Insulin resistance and hyperandrogenism are the characteristics of patients with polycystic ovary syndrome (PCOS).The paper evaluated the therapeutic effects of Diane 35 and metformin in the obese patients with polycystic ovary syndrome.Methods: 50 women with PCOS were included in the study. The serum sex hormones LH, FSH, T, PRL,A2 ,serum lipids (Tch, TG,HDL-ch,LDL-ch) were examined.Fasting insulin and glucose of 75g oral glucose tolerance test (at 60 minutes, 120 minutes) were measured.And then the patients whose IBM ≥25 were treated with insulin-sensitizing agents and antiandrogens (Diane 35 and metformin) for 3 months.Results: The combined Diane35 and metformin could effectively inhibit the synthetic of androgens of obese patients, lost weight, improve insulin resistance, serum lipids and menstrual regularity.Conclusion: Those obese PCOS women have more severe dysfunction in endocrine than those nonobese; not only antiandrogens but also insulin-sensitizing should be emphasized in the therapy of polycystic ovary syndrome.Combined anti-androgen and insulin-sensitizing treatment has additive benefits to women with PCOS.

关 键 词：PCOS 治疗 二甲双胍 患者 联合 临床探讨 肥胖者 肥胖型 FSH 体重 

分 类 号：R711.75[医药卫生—妇产科学] R587[医药卫生—临床医学]