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目的探讨二甲双胍对多囊卵巢综合征(PCOS)患者血清胰岛素样生长因子-1(IGF-1)及胰岛素样生长因子结合蛋白-1(IGFBP-1)水平的影响及其作用机制,明确二甲双胍治疗的临床效果。方法2002年1~11月对山西医科大学第二医院24例PCOS患者给予二甲双胍500mg,一日3次,8~24周治疗,比较治疗前后血清IGF-1、IGFBP-1、空腹胰岛素及睾酮水平,并对月经恢复、排卵、妊娠情况进行分析。结果二甲双胍可降低血清空腹胰岛素及睾酮水平,能显著升高IGFBP-1水平,治疗前后血清IGF-1水平差异无显著性。单纯二甲双胍治疗后月经恢复率为41·67%(10/24);自然排卵率为25·00%(6/24),自然妊娠率为12·50%(3/24)。二甲双胍加促排卵治疗共18个周期,排卵周期率66·67%(12/18),妊娠周期率为11·11%(2/18)。结论二甲双胍可以降低血清空腹胰岛素及睾酮水平,增高IGFBP-1水平,可以改善卵泡微环境,有助于月经恢复,提高促排卵和妊娠率,是治疗PCOS的重要手段。
Objective To investigate the effect of metformin on serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-1 (IGFBP-1) levels in patients with polycystic ovary syndrome (PCOS) The clinical effect. Methods From January to November 2002, 24 patients with PCOS in the Second Hospital of Shanxi Medical University were given metformin 500 mg three times a day for 8 to 24 weeks. The levels of serum IGF-1, IGFBP-1, fasting insulin and testosterone were compared before and after treatment , And menstruation recovery, ovulation, pregnancy situation analysis. Results Metformin decreased serum fasting insulin and testosterone levels, and significantly increased IGFBP-1 levels. There was no significant difference in serum IGF-1 levels before and after treatment. After metformin treatment, the recovery rate of menstruation was 41.67% (10/24). The rate of spontaneous ovulation was 25.00% (6/24) and the rate of spontaneous pregnancy was 12.5% (3/24). Metformin plus ovulation therapy for a total of 18 cycles, the ovulation cycle rate of 66.67% (12/18), the pregnancy cycle rate was 11.11% (2/18). Conclusions Metformin can reduce serum fasting insulin and testosterone levels and increase IGFBP-1 levels, which can improve follicle microenvironment, facilitate menstruation recovery and increase ovulation induction and pregnancy rate. It is an important treatment for PCOS.