摘要
目的:探讨二甲双胍(MTF)治疗多囊卵巢综合征(PCOS)不孕患者克罗米酚(CC)抵抗的效果.方法:22例CC抵抗PCOS不孕患者中合并胰岛素抵抗(IR)者20例,改为口服MTF,3 mo未妊娠者加服CC 3个周期.采取自身对照法,观察其用药前后排卵恢复情况、妊娠结局及血胰岛素水平、IR指数、体重指数(BMI)、性激素等指标的变化.结果:20例合并IR的患者服用MTF 6 mo后12例(60%)恢复排卵;其中10例(50%)妊娠,均未发生流产;8例无效,但用药6 mo后BMI、空腹胰岛素(I0),IR指数,T及LH/FSH均明显降低(P均<0.05).结论:CC抵抗PCOS不孕患者多数存在IR,应用MTF治疗可改善患者的排卵率及妊娠率,且经济方便.
AIM： To observe the treatment effect of metformin （MTF） on clomiphene （CC） -resistant infertile patients with polycystic ovary syndrome （PCOS）. METHODS： Among 22 CC-resistant patients with POCS, 20 patients showed insulin resistance （IR）. They firstly received MTF threapy for 3 months, later those who failed to conceive received MTF and CC threapy for another 3 months. At the end, the patients＇ sexual hormone, body mass index （BMI）, fasting insulin （I0 ）, 2-hour glucose to insulin ratio （G120/I120 ） and Homeostatic model assessment-insulin resistance index （HOMA-IR） were detected again and the results were compared with those of pre-treatment. At the same time, the ovulation and pregnancy rates were calculated. RESULTS： At the end of 6-month MTF treatment on 20 CC-resistant patients, 12 cases （60%） resumed their ovulation, 10 cases （50%） achieved pregnancy and did not abort. In the 8 patients who did not resume ovulation, however, the level of LH, LH/FSH, BMI, I0, G120/ I120 and HOMA-IR decreased significantly as compared with those of pre-treatment （ P 〈 0. 05 ）. CONCLUSION ： CC-resistant infertile women with PCOS are mostly associated with IR. MTF treatment is an economic and easily performed method which can be used to improve the ovulation and pregnancy rates.
出处
《第四军医大学学报》
北大核心
2006年第22期2068-2070,共3页
Journal of the Fourth Military Medical University
基金
唐山市科技攻关项目(05134614e)
关键词
多囊卵巢综合征
二甲双胍
妊娠
不育
氯录芬
胰岛素抗药性
polycystic ovary syndrome （ PCOS ）
metformin （ MTF ）
pregnancy
infertility
clomiphene
insulin resistance （IR）
