二甲双胍短期治疗对多囊卵巢综合征患者心理异常和代谢特征的影响  

Effect of sbort-term treatment with metformin on psychological distress and metabolic feature in patients withpolycystic ovary syndrome

作　　者：陶弢[1] 刘伟[1] 毛家亮[2] 贾芸[1] 张萍[1] 

机构地区：[1]上海交通大学医学院附属仁济医院内分泌代谢科,200127 [2]上海交通大学医学院附属仁济医院心内科,200127

出　　处：《中华内分泌代谢杂志》2013年第3期211-215,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然基金项目（81270875）,国家自然基金青年项目（81200628）,上海市自然基金项目（12ZR1417800）

摘　　要：目的探讨二甲双胍短期治疗对多囊卵巢综合征（PCOS）患者心理异常和代谢特征的影响。方法90例PCOS合并胰岛素抵抗（IR）的患者以随机数字表法随机分为3组，26例为单用二甲双胍组，36例为二甲双胍联合达英-35组，28例为安慰剂联合达英-35组，治疗3个月，比较治疗前后代谢指标的变化及心理状态的改变。PCOS的诊断根据2003年鹿特丹诊断标准。应用医院焦虑抑郁量表（HAD）评估患者的心理状态。结果与单用达英-35组患者相比，二甲双胍单用或联合达英-35组的体重指数（BMI）、腰围、腰臀比、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、空腹胰岛素水平和稳态模型评估的胰岛素抵抗指数（HOMA-IR）明显降低（均P〈0．05），高密度脂蛋白胆固醇（HDL-C）明显升高（P〈0．05），HAD表评分明显改善（P〈0．05）。与二甲双胍联合达英-35组相比，单用二甲双胍组的腰围、腰臀比、LDL．C和HOMA-IR水平明显降低（均P〈0．05），BMI、TG和HDL-．C改变不明显，HAD表评分改变差异无统计学意义（P〉0．05）。相关性分析提示二甲双胍单独治疗组代谢特征的改变与其抑郁和焦虑评分下降呈显著正相关（均P〈0．05）。结论二甲双胍短期治疗不仅能明显改善PCOS患者的代谢特征，同时能改善其心理状态。Objective To observe the effect of short-term treatment with metformin on psychological distress and metabolic feature in patients with polycystic ovary syndrome （PCOS）. Methods Ninety women were diagnosed as cases of PCOS based on the 2003 Rotterdam criteria. These patients were divided into three groups： group A, consisted of 26 subjects treated with metformin only; group B, 36 cases treated with metformin plus Dane-35 ; and group C, 28 cases treated with placebo and Dane-35. The treatment was carried out for 3 months. Clinical and metabolic parameters were observed. The psychological distress was evaluated by the hospital anxiety and depression scale（ HAD scale）. Results Compared with group C, patients in group A and B showed significantly lower body mass index（BMI） , waist circumference （ WC ） , waist-hip ratio （WHR） , serum fasting insulin, homeostasis model assessment for insulin resistance （ HOMA-IR ） , total cholesterol （ TC ） , triglyceride （ TG ） , low density lipoprotein- cholesterol（LDL-C） levels as well as anxiety and depression scores, but higher high density lipoprotein-cholesterol （HDL-C） levels （ all P〈0.05 ）. Compared with group A, patients in Group B had significantly higher WC, WHR, and LDL-C levels（ all P〈0.05 ）. No significant differences in BMI, TG, HDL-C, anxiety and depression scores were found between group A and B （ all P〉0.05 ）. In group A, a positive correlation was found between the changes of metabolic feature （BMI, WHR, and HOMA-IR ） and the changes of anxiety and depression scores （all P 〈 0.05）. Conclusion Short-term treatment with metformin will benefit patients with polycystic ovary syndrome, regarding psychological distress and metabolic features.

关 键 词：多囊卵巢综合征 心理异常 二甲双胍 治疗 

分 类 号：R711.75[医药卫生—妇产科学]