二甲双胍联合屈螺酮炔雌醇对多囊卵巢综合征患者卵巢体积及脂肪因子水平的影响  

Effect of Metformin Combined with Drospirenone Ethinyl Estradiol on Ovarian Volume and Adipokine Levels in Patients with Polycystic Ovary Syndrome

作　　者：王豫平 刘尚娟 海雪 WANG Yu-ping;LIU Shang-juan;HAI Xue(Department of Obstetrics and Gynecology,Nanyang Traditional Chinese Medicine Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中医院妇产科,南阳473000

出　　处：《中国合理用药探索》2024年第12期56-61,共6页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划项目(LHGJ20210072)。

摘　　要：目的:观察二甲双胍联合屈螺酮炔雌醇对多囊卵巢综合征(PCOS)患者卵巢体积及脂肪因子水平的影响。方法:选取2022年1月~2023年10月某院收治的94例PCOS患者作为研究对象,采用抽签法分为对照组和观察组,每组47例。对照组采用屈螺酮炔雌醇治疗,观察组采用二甲双胍联合屈螺酮炔雌醇治疗,两组均连续用药3个月经周期。比较两组患者卵巢体积、卵泡数目、性激素、脂肪因子、胰岛素抵抗差异,统计两组患者不良反应总发生率、自然妊娠率、流产率、足月妊娠率。结果:治疗3个月后,两组患者卵巢体积、卵泡数目、硫酸脱氢表雄酮(DHEAS)、睾酮(T)、雌二醇(E2)、黄体生成素/卵泡刺激素(LH/FSH)、脂肪素(apelin)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)均低于治疗前,且观察组低于对照组(P<0.05);网膜素(omentin)、C1q/肿瘤坏死因子相关蛋白9(CTRP9)均升高,且观察组高于对照组(P<0.05)。观察组自然妊娠率高于对照组(P<0.05)。两组患者流产率、足月妊娠率、不良反应总发生率比较无统计学差异(P>0.05)。结论:二甲双胍联合屈螺酮炔雌醇治疗PCOS可缩小卵巢体积,改善性激素、脂肪因子水平,增强胰岛素敏感性,提高自然妊娠率。Objective:To observe the effect of metformin combined with drospirenone ethinyl estradiol on ovarian volume and adipokine levels in patients diagnosed with polycystic ovary syndrome(PCOS).Methods:94 PCOS patients admitted to a certain hospital from January 2022 to October 2023 were selected as the research subjects.They were divided into a control group and an observation group using a lottery method,with 47 patients in each group.The control group received treatment with drospirenone ethinyl estradiol,while the observation group was treated with a combination of metformin and drospirenone ethinyl estradiol.Both groups received continuous medication for 3 menstrual cycles.Compare the differences in ovarian volume,follicle count,sex hormones,adipokines,and insulin resistance between two groups of patients,and calculate the total incidence of adverse reactions,natural pregnancy rate,miscarriage rate,and full-term pregnancy rate between the two groups of patients.Results:After three months of treatment,ovarian volume,follicle count,dehydroepiandrosterone sulfate(DHEAS),testosterone(T),estradiol(E2),luteinising hormone/follicle-stimulating hormone(LH/FSH),apelin,fasting insulin(FINS),insulin resistance index(HOMA-IR),and fasting plasma glucose(FPG)levels in both groups were significantly lower than those observed prior to treatment,while the levels in the observation group were significantly higher than those in the control group(P<0.05).Additionally,omentin and C1q/tumor necrosis factor-related protein 9(CTRP9)levels in both groups increased,while the levels in the observation group were significantly higher than those in the control group(P<0.05).The natural pregnancy rate in the observation group was higher than that in the control group(P<0.05).There was no statistically significant difference in the miscarriage rate,full-term pregnancy rate,and total incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion:Metformin combined with drospirenone ethinyl estradiol in the treatment of PCOS

关 键 词：二甲双胍 屈螺酮炔雌醇 多囊卵巢综合征 性激素 卵巢体积 脂肪因子 

分 类 号：R781[医药卫生—口腔医学]