二甲双胍治疗高胰岛素血症所致无排卵的临床观察

目的了解高胰岛素对血睾酮水平和排卵功能的影响,二甲双胍治疗高胰岛素血症无排卵的临床效果.方法对29例高胰岛素血症患者,进行12周的二甲双胍治疗,其中19例在二甲双胍治疗前后均接受氯米芬治疗1个周期.观察治疗前后血睾酮水平和排卵功能的变化.结果二甲双胍治疗前血睾酮水平为(2.7±1.6)nmol/L,治疗4周后为(1.9±1.0)nmol/L,两者比较,差异有显著性(P＜0.05).自发排卵,二甲双胍治疗前有3例,治疗后有10例(其中8例为原无排卵者)(P＜0.05);19例在二甲双胍治疗前后均服用过氯米芬,促排卵成功在二甲双胍治疗前有8例、治疗后有15例(P＜0.05).结论高胰岛素血症可引起血睾酮水平升高,排卵功能障碍.应用二甲双胍后胰岛素水平降低,睾酮水平下降,排卵功能有改善.

Effects of metformin on hyperinsulinemic anovulation

OBJECTIVE: To investigate the effects of metformin on serum testosterone (T) levels and ovulation in hyperinsulinemic women. METHODS: Twenty-nine patients with hyperinsulinemic anovulation were treated with metformin for 12 weeks. Among them 19 had history of clomiphene(CC) treatment with 11 cases failure. CC was given again after one month of metformin treatment. Serum T, luteinizing hormone, follicle-stimulating hormone, insulin(Ins) levels were measured after 4 weeks of treatment. Basic body temperature was also observed. RESULTS: Serum T and Ins levels declined significantly after 4 weeks of metformin treatment (2.7 +/- 1.6) nmol/L Vs (1.9 +/- 1.0) nmol/L, (49.2 +/- 34.1) mU/L Vs (25.3 +/- 23.9) mU/L, P < 0.05, P < 0.05 respectively]. Eight cases ovulated spontaneously and 8 cases with history of CC failure became ovulatory during CC treatment. CONCLUSIONS: Metformin is effective for suppressing serum T levels and improving the outcome of ovulation.