二甲双胍联合达英-35辅以促排卵治疗对多囊卵巢综合征患者糖脂代谢和内分泌及妊娠率的影响

doi:10.3969/j.issn.1671-7171.2018.04.007

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Abstract 【Objective】To investigate the effects of insulin sensitizer (metformin) combined with anti-androgens (Ethinyl estradiol cyproterone, Danein-35) and ovulation induction therapy on glycolipid metabolism, endocrine and pregnancy rate in patients with polycystic ovary syndrome (PCOS).【Methods】Ninety patients with PCOS were randomly divided into the treatment group (n=45) and the control group (n=45). All patients were treated with ethinylestradiol cyproterone acetate tablets, and the treatment group were additionally treated with metformin tablets. After 3 months of treatment, clomiphene (CC)-stimulated ovulation induction was used for promoting pregnancy. Before and after treatment, the physical indexes (BMI and WHR) of the two groups were measured. The levels of glucose and lipid metabolism, insulin resistance (IR) and endocrine indexes (HOMA-IR) were detected, and the status of ovulation and pregnancy was statistically analyzed.【Results】There were no significant differences in physical indicators, glucose and lipid metabolism, IR index and endocrine indexes between the two groups before the treatment (P>0.05). After treatment, BMI, waist hip ratio (WHR), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), fasting insulin (FINS), insulin resistance index (HOMA-IR), estradiol (E2), testosterone (T), luteinizing hormone (LH) and LH/ follicle stimulating hormone (FSH) in the two groups were significantly lower than those before treatment (P<0.05). After treatment, the above indices in the treatment group were significantly lower than those in the control group (P<0.05). On the other hand, after treatment, the dominant follicles and endometrial thickness of the treatment group were significantly higher than those of the control group (P<0.01), and the ovulation rate and pregnancy rate (73.33%, 57.78%, respectively) were significantly higher than those in the control group (53.33%, 35.56%, respectively) (P<0.05).【Conclusion】Insulin sensitizer combined with anti-androgens can help to relieve the IR and endocrine disorders, and significantly improve the ovulation rate and pregnancy rate in patients with PCOS.

Key words： Metformin/PD Dynein ATPase/PD Ovulation Induction Polycystic Ovary Syndrome Glycolipids/ME Pregnancy Rate

Received: 24 March 2017

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R711.75

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2018.04.007 OR http://www.jcr.net.cn/EN/Y2018/V35/I4/644

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