克罗米酚联合二甲双胍疗法对多囊卵巢综合征患者胰岛素抵抗及性激素水平的影响

目的 探究克罗米酚联合二甲双胍疗法对多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)对胰岛素抵抗(Homeostasis model assessment-insulin resistance,HOMA-IR)及性激素水平的影响。方法 选取于某医院治疗的PCOS患者90例作为研究对象,按照随机数字表法分为观察组与对照组,每组45例。对照组患者单纯给予克罗米酚治疗,观察组在对照组基础上联合二甲双胍治疗,对比两组治疗前后性激素水平,包括黄体生成素(luteinizing hormone,LH)、促卵泡激素(follicle-stimulatinghormone,FSH)、雌二醇(estradiol,E2)及睾酮(Testosterone,T)及HOMA-IR指数、卵泡发育情况及排卵率、妊娠率。结果 观察患者治疗后LH水平为(6.27±1.79)IU/L、FSH水平为(3.24±1.29)IU/L、T水平为(45.27±6.84)ng/dL、HOMA-IR指数为(0.98±0.69),均低于对照组的(8.59±1.83)IU/L、(4.71±1.52)IU/L、(67.36±9.41)ng/dL、HOMA-IR指数(2.01±0.28),观察组E2水平为(107.69±12.48)pmol/L,高于对照组的(79.94±11.36)pmol/L(P<0.05);观察组患者排卵率为82.22%、妊娠率为37.78%、子宫内膜厚度为(11.74±1.62)mm,分别高于对照组的62.22%、15.56%、(8.33±1.49)mm,观察组卵泡成熟时间为(10.36±1.26)d,低于对照组 (P<0.05)。结论 PCOS患者给予克罗米酚联合二甲双胍治疗有助于降低HOMA-IR指数,改善性激素水平,提高排卵率及妊娠率,值得在临床应用中推广。

Effects of clomiphene combined with metformin on insulin resistance and sex hormone levels in patients with polycystic ovary syndrome

Objective To investigate the effects of clomiphene combined with metformin on homeostasis model assessment-insulin resistance(HOMA-IR) and sex hormone levels in patients with polycystic ovary syndrome(PCOS).Methods Ninety PCOS patients treated in a hospital were selected and divided into a trial group and a control group according to the random number table method, with 45 cases each. The control group was treated with clomiphene, and the trial group was treated with metformin on the basis of the control group. The sex hormone levels before and after the treatment were tested and compared between the two groups, including luteinizing hormone(LH), follicle-stimulating hormone(FSH), estradiol(E2), testosterone(T), the HOMA-IR index, follicular development and ovulation rate, and pregnancy rate.ResultsAfter the treatment, the average LH level was(6.27±1.79) IU/L, FSH level was(3.24±1.29) IU/L, T level was(45.27±6.84) ng/dL,and the HOMA-IR index was(0.98±0.69) of the trial group, all were lower than those of the control group (8.59±1.83) IU/L,(4.71±1.52) IU/L,(67.36±9.41) ng/dL, HOMA-IR index(2.01±0.28)]. The average E2 level of the trial group was(107.69±12.48) pmol/L, which was higher than that of the control group(79.94±11.36) pmol/L(P<0.05). The ovulation rate was82.22%, the pregnancy rate was 37.78%, and the average endometrial thickness was(11.74±1.62) mm of the trial group,which were higher than those 62.22%, 15.56%, and(8.33±1.49) mm] of the control group, respectively. The average follicle maturation time of the trial group was(10.36±1.26) d, which was lower than that of the control group(P<0.05).Conclusion The administration of clomiphene combined with metformin in the patients with PCOS can help to reduce HOMA-IR index,improve sex hormone levels, and increase ovulation rate and pregnancy rate, and it is worthy of promotion in clinical applications.