摘要
目的:分析二甲双胍联合戊酸雌二醇、克罗米芬治疗多囊卵巢综合征(PCOS)所致不孕症对患者胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平及卵巢排卵功能的影响。方法:回顾性分析100例PCOS合并不孕症患者的临床资料。依据不同疗法分成对照组(二甲双胍和克罗米芬治疗)和研究组(二甲双胍联合戊酸雌二醇、克罗米芬治疗)。比较两组患者治疗前后体重、体重指数(BMI)、子宫内膜厚度、FINS、HOMA-IR水平及两组治疗后妊娠率、排卵率、早孕流产率、成熟卵泡数、不良反应发生情况。结果:①治疗后,两组体重、BMI及子宫内膜厚度均较治疗前降低(均P<0.05);两组治疗后子宫内膜厚度比较有统计学差异(P<0.05)。②治疗后,两组FINS、HOMA-IR水平均较治疗前降低,且研究组明显低于对照组(均P<0.05)。③治疗后,研究组妊娠、排卵率及成熟卵泡数高于对照组(均P<0.05),而两组早孕流产率比较无统计学差异(P>0.05)。④对照组并发症发生率为24.44%;研究组并发症发生率为18.18%,组间比较无统计学差异(P>0.05)。结论:在PCOS所致不孕症患者的治疗中,选用二甲双胍联合戊酸雌二醇、克罗米芬可有效降低FINS、HOMA-IR水平,改善卵巢排卵功能,提高其妊娠率,具有较高的临床应用价值。
Objective:To analyze the effects of metformin combined with estradiol valerate and clomiphene in the treatment of patients with infertility caused by polycystic ovary syndrome(PCOS)on the levels of insulin(FINS),homa insulin-resistance(HOMA-IR)and ovarian ovulation function.Methods:The clinical data of 100 PCOS patients with infertility were retrospectively analyzed.According to different treatments,they were divided into control group(metformin and clomiphene)and study group(metformin combined with estradiol valerate and clomiphene).The body weight,body mass index(BMI),endometrial thickness,FINS and HOMA-IR levels before and after treatment were compared between the two groups.The pregnancy rate,ovulation rate,early pregnancy abortion rate,the number of mature follicles,and the incidence of adverse reactions were compared between the two groups after treatment.Results:After treatment,the body weight,BMI and endometrial thickness of the two groups were lower(all P<0.05).There was a difference in endometrial thickness between the two groups after treatment(P<0.05).After treatment,the levels of FINS and HOMA-IR in the two groups were lower,and the level of the study group was significantly lower than that of the control group(all P<0.05).After treatment,the pregnancy rate,ovulation rate and the number of mature follicles in the study group were significantly higher than those in the control group(all P<0.05),while there was no difference in the early pregnancy abortion rate between the two groups(P>0.05).The incidence of complications in the control group was 24.44%,the incidence of complications in the study group was 18.18%,and there was no difference between the groups(P>0.05).Conclusion:Metformin combined with estradiol valerate and clomiphene was used in the treatment of infertility caused by PCOS can effectively reduce FINS and HOMA-IR levels,improve ovarian ovulation function,and increase the pregnancy rate,which has high clinical application value.
作者
梁新新
林睿
LIANG Xinxin;LIN Rui(Reproductive Medicine Center,Department of Obstetrics and Gynecology,Tangdu Hospital,Air Force Medical University,Xi’an 710038,China)
出处
《陕西医学杂志》
CAS
2023年第4期460-463,共4页
Shaanxi Medical Journal
基金
陕西省重点研发计划项目(2017SF-217)。
