黄体酮联合小剂量二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗先兆流产的疗效分析  

Efficacy analysis of progesterone combined with low-dose metformin in the treatment of polycystic ovary syndrome complicated with insulin resistance and threatened abortion

作　　者：阮靖 杨智宇 Ruan Jing;Yang Zhiyu(Hefei Maternal and Child Health Hospital,Obestetrics Department of Anhui Women and Children's Medical Center,Hefei,Anhui 230001,China)

机构地区：[1]合肥市妇幼保健院,安徽省妇女儿童医学中心产科,安徽合肥230001

出　　处：《感染、炎症、修复》2025年第1期53-56,60,共5页Infection Inflammation Repair

摘　　要：目的:分析多囊卵巢综合征(PCOS)合并胰岛素抵抗并先兆流产患者采用黄体酮联合小剂量二甲双胍治疗的效果。方法:选取2022年1月至2023年12月入院的180例PCOS合并胰岛素抵抗先兆流产者进行研究,随机分为对照组与观察组各90例。对照组采用黄体酮肌内注射治疗,观察组在上述治疗基础上加用小剂量二甲双胍,治疗过程持续3个月。评估两组患者子宫动脉血流变化[包括搏动指数(PI)、阻力指数(RI)和收缩期峰值流速/舒张末期流速(S/D)],观察两组患者治疗后3个月血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)、IL-17等炎症因子水平的变化,比较两组患者生殖激素水平[孕酮、特异性人绒毛膜促性腺激素(β-HCG)]和糖代谢指标[糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)];治疗后对患者进行随访,记录患者流产率,统计不良妊娠结局发生率。结果:相关药物干预前,两组间各观察指标水平均无显著差异(P>0.05)。治疗后,两组PI、RI和S/D、IL-6、TNF-α、HMGB1、IL-17、HbA1c和HOMA-IR水平均显著降低(P<0.05),孕酮和β-HCG水平均明显升高(P<0.05),观察组变化较对照组更显著(P<0.05)。两组各期流产率及流产总发生率无明显差异(P>0.05)。结论:黄体酮联合小剂量二甲双胍可降低炎症因子水平并增加患者生殖激素水平,从而发挥对PCOS合并胰岛素抵抗先兆流产者的安胎作用,降低不良妊娠结局发生率。Objective:To analyze the effect of progesterone combined with low-dose metformin in the treatment of polycystic ovary syndrome(PCOS)patients with insulin resistance and threatened abortion.Methods:A total of 180 PCOS patients complicated with insulin resistance threatened abortion were admitted to Hefei Maternal and Child Health Hospital from January 2022 to December 2023.They were randomly divided into two groups,the control group(n=90)and the observation group(n=90).The control group received the treatment of progesterone intramuscular injection,and the observation group received low-dose metformin for oral medication on the basis of the above treatment.The treatment lasted for 3 months:The changes of uterine artery blood flow[including pulse index(PI),resistance index(RI)and peak systolic velosity/end diastolic velosity(S/D)]were evaluated in the two groups.Serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high mobility group protein B1(HMGB1)and interleukin-17(IL-17)and other inflammatory factors were observed in the two groups after 3 months of treatment.The levels of reproductive hormones[progesterone,specific human chorionic gonadotropin(β-HCG)]and glucose metabolism indexes[glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)]were compared between the two groups.After treatment,the patients were followed up,the abortion rate was recorded,and the incidence of adverse pregnancy outcomes was counted.Results:Before treatment,there was no significant differencein the levels of each observation index between the two groups(P>0.05).After treatment,PI,RI and S/D,IL-6,TNF-α,HMGB1,IL-17,HbA1c and HOMA-IR in both groups were significantly decreased(P<0.05),while the levels of progesterone and β-HCG were significantly increased(P<o.05),and the changes in the observation group were more significant than those in the control group(P<0.05).There were no significant differences in the abortion rate and the total incidence of abortion between the two groups(P>0.05).Conclusions:Progesterone combined

关 键 词：多囊卵巢综合征 胰岛素抵抗 先兆流产 黄体酮 二甲双胍 

分 类 号：R711.1[医药卫生—妇产科学] R714.21[医药卫生—临床医学]