二甲双胍联合醋酸环丙孕酮治疗多囊卵巢综合征的价值分析  

Clinical Value of Metformin Combined with Cyproterone Acetate in the Treatment of Polycystic Ovary Syndrome

作　　者：李雪丽 王鑫丹 高干 杨兴兴 刘春明 LI Xueli;WANG Xindan;GAO Gan;YANG Xingxing;LIU Chunming(Department of Medieal Laboratory,Llizhou Maternal and Child Healthcare Hospital,Lliuzhou,Cuangxi,China 545001)

机构地区：[1]广西壮族自治区柳州市妇幼保健院医学检验科,广西柳州545001

出　　处：《中国药业》2020年第24期63-67,共5页China Pharmaceuticals

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题[Z20180023]。

摘　　要：目的探讨多囊卵巢综合征牗PCOS牘患者应用二甲双胍联合醋酸环丙孕酮治疗对血清脂质代谢、性激素水平及胰岛素抵抗的影响。方法选取医院2016年1月至2019年2月收治的PCOS患者100例,按治疗方式的不同分为A组(醋酸环丙孕酮,41例)和B组(二甲双胍联合醋酸环丙孕酮,59例)。结果治疗前,两组患者的血清性激素犤促卵泡生成素(FSH)、黄体生成激素(LH)、睾酮(T)、雌二醇(E2)犦、胰岛素抵抗相关指标及卵巢形态学参数无显著差异(P>0.05);治疗12周后,B组患者的血清脂质代谢指标犤载脂蛋白A1(ApoA1)、载脂蛋白E(ApoE)及ApoB/ApoA1比值犦、LH,T,E2水平均低于A组,载脂蛋白B牗ApoB牘水平高于A组(P<0.05);空腹血糖(FBG)、空腹胰岛素(FINS)均低于A组,胰岛素敏感指数(ISI)、胰岛素抵抗指数(HOMA-IR)均高于A组(P<0.05);卵泡数、卵巢间质面积(SA)、卵巢总面积(TA)及两者比值(SA/TA)均低于A组,排卵率高于A组(P<0.05);两组患者治疗期间的不良反应发生率无显著差异(P>0.05)。结论二甲双胍联合醋酸环丙孕酮治疗PCOS,可调节患者的脂质代谢,改善性激素紊乱,减轻胰岛素抵抗,增加胰岛素敏感性,改善卵巢形态,促进排卵。Objective To investigate the efect of metformin combined with cyprolterone acetate on the serum lipid metabolism,sex hor-mones and insulin resistance(IR)in patients wih polyeystic ovary syndrome(PCO8).MethodsTotally 100 patients with PCOS admittedto our hospital from January 2016 to February 2019 were selected and divided into group A(cyproterone acetale,n=41)and group B(metformin combined with cypoterone acetate,n=59)acconling to the dfferent treatment methods.Results Before treatment,there wasno significant difference in serum sex hormoneslfollicle stimulating hormone(FSH),luteinizing homone(LH)testosterone(T)and estadiol(E),nsulin resistance-related indexes or ovarian morphology between the two groups(P>0.05).After 12 weeks of treatment,thelevels of serum lipid metawolism indexes[apolipopotein A1(ApoA1),apolipoprotein E(ApoE)and ApoB/ApoA1],LH,T and Ein groupB were lower than those in group A,while the level of apolipoprotein B(ApoB)in group B was higher than that in group A(P<0.05).The levels of fasting blood glucose(FBG)and fasting insulin(FINS)in group B were lower than those in group A,while the insutlinsensitivity index(ISI)and homeostasis model assessment of insulin resistance(HOMA-IR)in group B were higher than those in groupA(P<0.05).The follicles number,ovarian stromal area(SA),total area(TA)and SA/TA in group B were lower than those in groupA,while the ovulation rate in group B was higher than that in group A(P<0.05).There was no significant difference in the inci-dence of adverse reactions between the two groups during the treatment(P>0.05).Conclusion Metformin combined with cyproterone acetate in the treatment of patients with PCOS can regulate lipid metabolism,improve the disordd of sex hormone,reduce insulin resis-tance,increase insulin sensitivity,improve ovarian morphology and promole ovulation of patients.

关 键 词：多囊卵巢综合征 醋酸环丙孕酮 二甲双胍 性激素 胰岛素抵抗 脂代谢 排卵 

分 类 号：R969.4[医药卫生—药理学] R977.13[医药卫生—药学]