二甲双胍治疗多囊卵巢综合征改善生化指标效果观察
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摘要
目的观察二甲双胍治疗多囊卵巢综合征(polycystic ovary syndrome,PCOS)前后性激素、血脂和胰岛素水平变化。方法选择2015～2017年深圳市龙华区人民医院收治的60例PCOS患者,进行二甲双胍治疗,从月经第3 d开始口服,每次500 mg,tid,连用21 d后停药7 d为1个疗程,连用3个疗程。比较患者治疗前后的性激素、血脂和胰岛素抵抗水平。结果治疗后,患者黄体生成素、促卵泡刺激素、血清睾酮、雌二醇、孕酮、抗苗勒氏管激素、游离雄激素指数、总胆固醇、甘油三醇、空腹胰岛素、胰岛素抵抗指数均较治疗前明显下降,性激素结合球蛋白、高密度脂蛋白明显升高,差异均有统计学意义(P<0.05),硫酸脱氢表雄酮、泌乳素、糖化血红蛋白、空腹血糖治疗前后比较,差异无统计学意义(P>0.05)。结论二甲双胍可在一定程度上改善PCOS患者激素水平、血脂水平和胰岛素抵抗。
Objective To observe the changes of sex hormones, blood lipids and insulin levels before and after metformin treatment of polycystic ovary syndrome(PCOS). Methods 60 PCOS patients admitted to People's Hospital of Longhua District in Shenzhen from 2015 to 2017 were treated with metformin. Oral administration was started from the 3rd day of menstruation, 500 mg each time, tid, and stopped 7 days after continuous use for 21 days as a course of treatment, used 3 courses. The levels of sex hormones, blood lipids and insulin resistance before and after treatment were compared. Results After treated by metformin, LH, FSH, T, E_2, P, AMH, FAI TC,TG,FINS, HOMA-IR of patients were significantly lower than before treatment, SHBG and HDL were significantly increased, the differences were statistically significant(P<0.05), DHEA-S, PRL glycosylated hemoglobin and FBG before and after treatment, the difference was not statistically significant(P>0.05). Conclusion Metformin can improve hormone levels, blood lipid levels and insulin resistance in PCOS patients to some extent.
Objective To observe the changes of sex hormones, blood lipids and insulin levels before and after metformin treatment of polycystic ovary syndrome(PCOS). Methods 60 PCOS patients admitted to People's Hospital of Longhua District in Shenzhen from 2015 to 2017 were treated with metformin. Oral administration was started from the 3rd day of menstruation, 500 mg each time, tid, and stopped 7 days after continuous use for 21 days as a course of treatment, used 3 courses. The levels of sex hormones, blood lipids and insulin resistance before and after treatment were compared. Results After treated by metformin, LH, FSH, T, E_2, P, AMH, FAI TC,TG,FINS, HOMA-IR of patients were significantly lower than before treatment, SHBG and HDL were significantly increased, the differences were statistically significant(P<0.05), DHEA-S, PRL glycosylated hemoglobin and FBG before and after treatment, the difference was not statistically significant(P>0.05). Conclusion Metformin can improve hormone levels, blood lipid levels and insulin resistance in PCOS patients to some extent.
引文
[1] Nathan N,Sullivan SD.The utility of metformin therapy in reproductive-aged women with polycystic ovary syndrome (PCOS)[J].Curr Pharm Biotechnol,2014,15(1):70-83.
[2] Shafiee MN,Khan G,Ariffin R,et al.Preventing endometrial cancer risk in polycystic ovarian syndrome (PCOS) women:could metformin help?[J].Gynecol Oncol,2014,132(1):248-253.
[3] 李静,任晔亚,张怿溟,等.达因-35及二甲双胍预处理后联合来曲唑治疗氯米芬抵抗多囊卵巢综合征的疗效分析[J].河北医科大学学报,2011,32(3):286-289.
[4]杨昱,刘超.2013年美国内分泌学会多囊卵巢综合征诊疗指南解读 [J].中华内分泌代谢杂志,2014,30 (2):89-92.
[5] 刘青青,王姣珍,马海芬.达英-35联合二甲双胍治疗多囊卵巢综合征的临床疗效观察[J].中国现代医生,2013,51(36):46-48.
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[8] 林丹,郭遂群,赵丽琴,等.盐酸二甲双胍对多囊卵巢综合征患者排卵及子宫内膜容受性的影响 [J].海南医学院学报,2014,20 (4):528-530.
[9] Moll E.Metformin in polycystic ovary syndrome [D].2013.
[10] 杨志勤,张学会,唐新生.二甲双胍对多囊卵巢综合征患者血脂代谢及胰岛素抵抗状态的影响[J].实用临床医药杂志,2014,18(23):63-66.
[11] 任春琼,肖涌,李毅,等.二甲双胍对多囊卵巢综合征患者性激素水平,胰岛素抵抗及相关指标的影响 [J].中国药房,2016,27(27):3791-3794.
[12] 段志芳,高学娟,闫绍颖,等.多囊卵巢综合征患者抗苗勒激素与其他指标相关性研究 [J].海峡药学,2010,22(4):73-75.
[2] Shafiee MN,Khan G,Ariffin R,et al.Preventing endometrial cancer risk in polycystic ovarian syndrome (PCOS) women:could metformin help?[J].Gynecol Oncol,2014,132(1):248-253.
[3] 李静,任晔亚,张怿溟,等.达因-35及二甲双胍预处理后联合来曲唑治疗氯米芬抵抗多囊卵巢综合征的疗效分析[J].河北医科大学学报,2011,32(3):286-289.
[4]杨昱,刘超.2013年美国内分泌学会多囊卵巢综合征诊疗指南解读 [J].中华内分泌代谢杂志,2014,30 (2):89-92.
[5] 刘青青,王姣珍,马海芬.达英-35联合二甲双胍治疗多囊卵巢综合征的临床疗效观察[J].中国现代医生,2013,51(36):46-48.
[6] Milewicz A.Metformin for polycystic ovary syndrome[J].Endokrynol Pol,2013,64(5):409.
[7] Weickert MO,Hodges P,TAN B-k,et al.Neuroendocrine and endocrine dysfunction in the hyperinsulinemic PCOS patient:the role of metformin[J].Minerva Endocrinol,2012,37(1):25-40.
[8] 林丹,郭遂群,赵丽琴,等.盐酸二甲双胍对多囊卵巢综合征患者排卵及子宫内膜容受性的影响 [J].海南医学院学报,2014,20 (4):528-530.
[9] Moll E.Metformin in polycystic ovary syndrome [D].2013.
[10] 杨志勤,张学会,唐新生.二甲双胍对多囊卵巢综合征患者血脂代谢及胰岛素抵抗状态的影响[J].实用临床医药杂志,2014,18(23):63-66.
[11] 任春琼,肖涌,李毅,等.二甲双胍对多囊卵巢综合征患者性激素水平,胰岛素抵抗及相关指标的影响 [J].中国药房,2016,27(27):3791-3794.
[12] 段志芳,高学娟,闫绍颖,等.多囊卵巢综合征患者抗苗勒激素与其他指标相关性研究 [J].海峡药学,2010,22(4):73-75.