二甲双胍联用克罗米酚与腹腔镜下电凝术治疗多囊卵巢综合征合并不孕患者的疗效比较

目的:观察二甲双胍联用克罗米酚(CC)与腹腔镜下卵巢表面电凝术治疗多囊卵巢综合征(PCOS)合并不孕患者的疗效比较。方法:对确诊为胰岛素抵抗(IR)的48例PCOS合并不孕患者,随机分成两组:①双胍组(n=26):采用二甲双胍联用克罗米酚治疗;②电凝组(n=22),采用在腹腔镜下卵巢表面电凝术治疗。治疗前后采用免疫化学发光法检测黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、空腹血糖(FG)、空腹胰岛素(Fins),并观察月经、排卵和妊娠情况。结果:两组治疗后与治疗前比较:①LH、FSH、T、FG和Fins5项指标中,LH、T和Fins差异均非常显著(P<0.01);FSH和FG差异无显著性(P>0.05)。②两组治疗后排卵的例数与月经周期改善情况比较差异无显著性(P>0.05),但妊娠例数在电凝组显著高于双胍组(P<0.01)。结论:二甲双胍联用克罗米酚治疗PCOS能降低LH、T、Fins及改善月经周期,但较腹腔镜下卵巢表面电凝术治疗后妊娠率低。

A comparison of effects between metformin plus clomephene citrate and electro-coagulation therapy under laparoscope in patients with polycystic ovarian syndrome complicated with infertility

Objective:To compare therapeutic effects between metformin plus clomephene citrate(CC) and electrocoagulation therapy under laparoscope in patients with polycystic ovarian sydrome(PCOS) complicated with infertility.Methods:Forty-eight PCOS with infertility divided into metformin group(n=26)with metformin plus CC and electrocoagulation group(n=22).Before and affer treatment,luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),fasting blood glucose(FG)and fasting insulin(Fins)were determined by immunochemiluminescence technique.Results:The levels of LH、T and Fins were significantly lower in both two groups(P<0.01),and pregnant rate in electrocoagulation group was obviously higher than that of metformin group(P<0.01).Conclusion:Metfomin plus CC could decline LH,T and Fins in PCOS with infertility and improve menses cycle,but pregnant rate with eletrocoagulation was significanthy higher than that with metformin.