二甲双胍联合复方醋酸环丙孕酮治疗青春期PCOS疗效分析  

Effects of Combined Use of Metformin and Cyproterone Acetate in Adolenscents with Polycystic Ovary Syndrome

作　　者：杜静[1] 梁晓燕[1] 

机构地区：[1]中山大学附属第一医院生殖中心,广州510080

出　　处：《国际妇产科学杂志》2008年第1期69-71,共3页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金(编号:30571956;30300372);广东省自然科学基金(编号:31690;21874);GZST(编号:2004J-C0111);广东省科技基金(编号:2006B35901001)

摘　　要：目的:探讨二甲双胍联合复方醋酸环丙孕酮(CPA)对青春期多囊卵巢综合征(PCOS)患者的临床疗效。方法:将23例青春期PCOS患者随机分为两组,A组(n=13)给予复方CPA,B组(n=10)联合给予复方CPA和二甲双胍(1500mg/d),用药3个月后,观察治疗前后临床表现、血浆性激素水平、空腹血糖、空腹胰岛素水平的变化,以及短期对氯米芬(CC)促排卵的反应和黄体生成激素(LH)反跳率。结果:治疗3个月后,两组患者卵泡刺激素(FSH)、LH水平、LH/FSH比值较治疗前明显降低,有显著性差异(P<0.05),多毛、痤疮症状改善,雄激素水平无明显变化。在A组稳态模型胰岛素抵抗指数(HOMA-IR)较治疗前升高,差异有统计学意义(P<0.05)。A组8例患者(61.55%)和B组6例患者(60.00%)对CC无反应,在3个周期CC后,A组有8例患者(61.55%)和B组3例患者(30.00%)出现LH反跳,B组的LH反跳比例低于A组,但无统计学差异(P>0.05)。结论:复方CPA联合二甲双胍治疗青春期PCOS可以改善患者的临床症状,降低LH水平,降低LH反跳率,可作为青春期PCOS治疗的选择。Objective：To analyze the effects of the combined use of adjuvant metformin with cyproterone acetate （CPA） in adolescents with polycystic ovary syndrome（PCOS）.Methods：Twenty-three adolescent girls with PCOS were randomly separated into two groups： group A（n =13）received CPA alone; group B（n =10）received CPA plus 1 500 mg of metformin daily for 3 months. Clinical features, sexual hormone level, fasting blood glucose, fasting insulin, and sensitivity to clomiphene citrate（CC）and leutinizing hormone（LH）get-back rate were evaluated at baseline and after 3 months of treatment. Results：After 3 months of treatment, the serum follicle stimulating hormone（FSH）, LH, and LH/FSH ratio decreased significantly in both groups（P〈0.05）, and hirsutism and acne both improved, although there was no significant change in the testosterone level, HOMA-IR increased in the group only treated with Diane-35（P〈0.05）. Of the original patients, 8 patients in Group A（61.55%） and 6 patients in Group B（60.00%） failed to respond to clomiphene citrate, and 8 patients in Group A（61.55%）and 3 patients in Group B（30.00%） returned to a higher LH level after three cycles of CC administration. There was a tendency toward a greater decrease in Group B than Group A, but the difference was not significant（P〉0.05）. Conclusion：The combination of metformin with intermittent application of the compound CPA could not only improve the clinical features, and also lead to decrease LH level and LH get-back rate, may be an appropriate alternative for adolescents with polycystic ovary syndrome.

关 键 词：多囊卵巢综合征 青春期 二甲双胍 复方醋酸环丙孕酮 

分 类 号：R711.75[医药卫生—妇产科学] R587.1[医药卫生—临床医学]