二甲双胍治疗26例胰岛素抵抗型多囊卵巢综合征的临床研究  

Metformin treated of insulin resistance type polycystic ovarian syndrome patients:A clinical research of 26 cases

作　　者：张君莉[1] 黄晓燕[1] 

机构地区：[1]宁波市医疗中心李惠利医院妇科,浙江宁波315040

出　　处：《中国现代医生》2013年第3期74-75,78,共3页China Modern Doctor

基　　金：浙江省宁波市自然科学基金(2008A610081)

摘　　要：目的观察二甲双胍治疗胰岛素抵抗型多囊卵巢综合征的临床疗效以及对患者血清中炎症因子、内分泌指标、糖代谢指标水平的影响。方法回顾性分析2010年5月～2011年12月住院的PCOS伴有胰岛素抵抗患者26例,检测血清空腹血糖(FBG)、空腹胰岛素(FINS)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)和睾酮(T)的含量;酶联免疫吸附试验(ELISA)方法检测血清IL-18、TNF-α、CRP的含量。结果 26例胰岛素抵抗型多囊卵巢综合征患者经二甲双胍治疗后,10例月经稀发患者恢复正常7例(70.00%);13例继发闭经患者恢复排卵月经6例(46.15%);15例不孕症患者在治疗观察中怀孕3例(20.00%)。按疗程服用二甲双胍后,与治疗前相比,治疗后E2、FSH水平无明显变化,差异无统计学意义(P>0.05);治疗后FPG、FINS、HOMA-IR、T、LH、IL-18、TNF-α、CRP明显降低,差异有统计学意义(P<0.05,P<0.01)。结论二甲双胍能够有效调节胰岛素抵抗型多囊卵巢综合征患者血清中炎症因子、内分泌、糖代谢指标水平,使患者恢复月经周期及促进排卵,提高受孕,阻断多囊卵巢综合征伴胰岛素抵抗诱导的心血管疾病发病高危因素。Objective To observe the metformin treated insulin resistance type polycystic ovarian syndrome patients for clinical curative effect, and metformin influence the level of patients serum inflammation factors, endocrine and sugar. Methods To analyse retrospectively 26 cases of insulin resistance type polycystic ovarian syndrome patients in May 2010 to December 2011, and to measure serum fasting blood sugar, fasting insulin, follicle-stimulating hormone, leuteinizing hormone, estradiol and testosterone content; ELISA tested content ？Interleukin - 18, Tumor necrosis factor -α, C-reactive protein in serum. Results A total of 26 cases of insulin resistance type polycystic ovarian syndrome patients were treated by the metformin, 10 cases of menstrual rare cases, restored normal 7 （70.00%）; 13 cases of patients with secondary amenorrhea, 6 cases of oviposit period were recovery （46.15%）; During the treatment ,15 cases of infertility patients were observed that 3 cases of pregnancy （20.00%）. According to the course of taking metformin later, compared with before treatment group, E2 and FSH level of after treatment group was not changed, the difference was not statistically significant （P 〉 0.05）; FINS, FPG, HOMA-IR, T, LH, IL-18, TNF-α, CRP of after treatment group were reduced, the difference was statistically significant （P 〈 0.05, P 〈 0.01）. Conclusion Metformin can regulate the level of serum inflammation factors, endocrine and sugar in polycystic ovarian syndrome patients with insulin resistance, it can make patient restore menstrual cycles and promote ovulation, improve the conception, blocking risk factors that polycystic ovarian syndrome with insulin resistance which induced of cardiovascular disease.

关 键 词：二甲双胍 胰岛素抵抗型多囊卵巢综合征 炎症因子 内分泌 糖代谢 

分 类 号：R587.2[医药卫生—内分泌]