论文部分内容阅读
[目的]探讨二甲双胍联合达英-35治疗多囊卵巢综合征(PCOS)的疗效及对妊娠结局的影响.[方法]选取94例胰岛素抵抗(IR)型PCOS患者,随机分为观察组和对照组,每组47例.对照组采用达英-35治疗,观察组采用达英-35联合二甲双胍治疗,治疗3个月经周期.比较两组治疗前后糖脂代谢、激素水平、子宫内膜厚度、排卵率、妊娠率和流产率.[结果]治疗后两组体质量指数(BM I)、空腹血糖(FPG)、空腹胰岛素(FINS)和IR水平均显著下降,且观察组下降幅度显著高于对照组(P <0.05);观察组治疗后总胆固醇(TC)和三酰甘油(TG)显著低于治疗前和对照组治疗后,差异具有统计学意义(P <0.05);治疗后两组促卵泡激素(FSH)、黄体生成素(L H)、L H/FSH、睾酮(T)显著下降,雌二醇(E2)显著上升,子宫内膜厚度显著变薄,且观察组治疗后变化幅度大于对照组,差异具有统计学意义(P <0.05);治疗后观察组排卵率、妊娠率分别为89.36%、55.32%,显著高于对照组的68.09%、34.04%,流产率为4.26%,显著低于对照组的17.02%,其差异均有统计学意义(P < 0.05).[结论]二甲双胍联合达英-35可调节IR型PCOS患者的糖、脂代谢紊乱,降低IR,改善内分泌失调和子宫内膜异常增生,促进排卵,提高妊娠率和降低流产率,值得临床推广应用.“,”[Objective]To analyze the effect of metformin(MET)combined with Diane-35 on pregnancy out-comes of patients with polycystic ovary syndrome(PCOS).[Methods]Ninety-four patients with insulin resistant (IR)PCOS were randomly divided into the MET group and control group,47 cases in each group.The control group were treated with Diane-35 while the observation group were treated with Diane-35 and MET.After 3 men-strual cycles,the levels of glucose and lipid metabolism,hormone levels,endometrial thickness,ovulation rate, pregnancy rate and abortion rate were compared between the two groups before and after treatment.[Results]Af-ter treatment,the body mass index,fasting blood glucose,fasting insulin and IR levels in the two groups de-creased significantly,and the decreasing range in MET group was greater than that in the control group(P <0.05).After treatment,the total cholesterol and triglyceride in MET group were significantly lower than those be-fore treatment and those in the control group after treatment,the difference was statistically significant(P <0.05).After treatment,the follicle stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH and testos-terone decreased significantly,the estradiol increased significantly,and the endometrial thickness was significantly thinner.The changes in MET group after treatment were more obvious than those in the control group(P <0.05).After treatment,the ovulation rate,pregnancy rate and abortion rate in the MET group were 89.36%, 55.32% and 4.26% while those in the control group were 68.09%,34.04% and 17.02%,the difference was statis-tically significan(P <0.05).[Conclusion]Metformin combined with Dain-35 can regulate the disorder of glucose and lipid metabolism,decrease IR,improve endocrine disorders and endometrial dysplasia,increase pregnancy rate and reduce abortion rate It is worth popularizing clinical application.