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目的探讨二甲双胍对合并胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)患者内分泌功能的影响。方法将合并IR的PCOS患者57例纳入研究,予二甲双胍口服,起始剂量0.25g,3次/d,待患者胃肠道耐受后增至0.5g,3次/d,疗程12周。评价治疗前及治疗后12周患者卵巢体积大小,促性腺激素、性激素和性激素结合球蛋白及血糖和胰岛素水平。结果用药12周后,⑴患者左侧及右侧卵巢体积均明显缩小(t=2.81t,=2.20),差异有显著性;患者LH水平、LH/FSH比值和睾酮水平下降(t=2.19,t=2.56,t=1.85),SHBG水平升高(t=2.02),差异有显著性;FSH水平则无显著变化。⑵0min和120min两个时点的血糖较治疗前无明显变化,但胰岛素水平在两个时点均则较治疗前明显降低(t=1.92,t=2.15),差异均有显著性。结论二甲双胍通过改善胰岛素抵抗降低胰岛素水平,使PCOS患者内分泌紊乱获益。
Objective To investigate the effect of metformin on endocrine function in patients with polycystic ovary syndrome (PCOS) complicated with insulin resistance (IR). Methods Fifty-seven PCOS patients with IR were enrolled in the study. Metformin was orally given at the initial dose of 0.25g for 3 times daily until the patient’s gastrointestinal tolerance was increased to 0.5g three times daily for 12 weeks. The ovarian volume, gonadotropin, sex hormones and sex hormone binding globulin and blood glucose and insulin levels were evaluated before treatment and 12 weeks after treatment. Results After 12 weeks of treatment, (1) the ovarian volumes in the left and right sides of the patients were significantly reduced (t = 2.81t, = 2.20), and the difference was significant. The LH level, LH / FSH ratio and the testosterone level decreased t = 2.56, t = 1.85), SHBG level increased (t = 2.02), the difference was significant; FSH level did not change significantly. (2) There was no significant difference in blood glucose between the two points at 0min and 120min, but the level of insulin was significantly lower at both time points than before treatment (t = 1.92, t = 2.15). The differences were significant. Conclusion Metformin can reduce the level of insulin by improving insulin resistance, which can benefit the endocrine disorders in patients with PCOS.