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目的探讨二甲双胍对多囊卵巢综合征(PCOS)患者的疗效及其心理健康和血清单胺类神经递质浓度的关系。方法 (1)给PCOS患者二甲双胍片口服治疗12周。治疗前后分别计算PCOS患者的BMI指数和腰臀比(WHR),检测其卵泡刺激素、黄体生成素和睾酮、硫酸脱氢表雄酮、性激素结合球蛋白的含量水平,同时检测抑郁焦虑情况。(2)将所有入组者分为单一抑郁或焦虑组、抑郁伴焦虑组和非PCOS组患者,分析上述患者的HAMA、HAMD量表评分及其血清单胺类神经递质浓度。结果 (1)治疗后,PCOS患者的BMI、WHR及血清T、DHEAS、LH、FSH、SHBG含量均有不同程度的改善,焦虑抑郁评分也明显下降;(2)与非PCOS组相比,单一抑郁或焦虑组的E、NE浓度及抑郁伴焦虑组的HVA、5-HIAA浓度明显低,差异有统计学意义;(3)与单一抑郁或焦虑组相比,抑郁伴焦虑组中E、NE浓度明显高,差异有统计学意义。结论二甲双胍口服药物不仅能改善PCOS患者的代谢产物,而且还能改善PCOS患者的心理状态及异常情绪。
Objective To investigate the efficacy of metformin in patients with polycystic ovary syndrome (PCOS) and its relationship with mental health and serum monoamine neurotransmitter concentrations. Methods (1) PCOS patients metformin tablets oral treatment for 12 weeks. The BMI index and WHR of PCOS patients were calculated before and after treatment. The levels of follicle stimulating hormone, luteinizing hormone and testosterone, dehydroepiandrosterone sulfate and sex hormone binding globulin were measured, and the status of depression and anxiety was also tested. (2) All patients were divided into single depressive or anxiety group, depression with anxiety group and non-PCOS group. The HAMA and HAMD scores and serum monoamine neurotransmitter concentrations were analyzed. Results (1) The levels of BMI, WHR, serum T, DHEAS, LH, FSH and SHBG in PCOS patients all improved to some extent and the scores of anxiety and depression were significantly decreased after treatment. (2) Compared with non-PCOS group, The levels of E and NE in depression and anxiety groups and HVA and 5-HIAA concentrations in depression and anxiety groups were significantly lower than those in depression and anxiety groups (P <0.05). (3) The concentration was significantly higher, the difference was statistically significant. Conclusion Metformin oral drug can not only improve the metabolites of patients with PCOS, but also improve the psychological status and abnormal mood in PCOS patients.