二甲双胍治疗多囊卵巢综合征克罗米酚抵抗疗效观察

目的: 探讨二甲双胍(MTF)治疗多囊卵巢综合征(PCOS)不孕患者克罗米酚(CC)抵抗的效果. 方法: 22例CC抵抗PCOS不孕患者中合并胰岛素抵抗(IR)者20例,改为口服MTF,3 mo未妊娠者加服CC 3个周期. 采取自身对照法,观察其用药前后排卵恢复情况、妊娠结局及血胰岛素水平、IR指数、体重指数(BMI)、性激素等指标的变化. 结果: 20例合并IR的患者服用MTF 6 mo后12例(60%)恢复排卵;其中10例(50%)妊娠,均未发生流产;8例无效,但用药6 mo后BMI、空腹胰岛素(I0),IR指数,T及LH/FSH均明显降低(P均＜0.05). 结论: CC抵抗PCOS不孕患者多数存在IR,应用MTF治疗可改善患者的排卵率及妊娠率,且经济方便.

Treatment effect of metformin on clomiphene-resistant patients with polycystic ovary syndrome

AIM: To observe the treatment effect of metformin(MTF)on clomiphene(CC)-resistant infertile patients with polycystic ovary syndrome(PCOS).METHODS: Among 22 CC-resistant patients with POCS,20 patients showed insulin resistance(IR).They firstly received MTF threapy for 3 months,later those who failed to conceive received MTF and CC threapy for another 3 months.At the end,the patients' sexual hormone,body mass index(BMI),fasting insulin(I_0),2-hour glucose to insulin ratio (G_(120)/I_(120)) and Homeostatic model assessment-insulin resistance index(HOMA-IR) were detected again and the results were compared with those of pre-treatment.At the same time,the ovulation and pregnancy rates were calculated.RESULTS: At the end of 6-month MTF treatment on 20 CC-resistant patients, 12(cases)(60%) resumed their ovulation,10 cases(50%) achieved pregnancy and did not abort.In the 8 patients who did not resume(ovulation,) however,the level of LH,LH/FSH,BMI,I_0,G_(120)/I_(120) and HOMA-IR decreased significantly as compared with those of pre-treatment(P<0.05).CONCLUSION: CC-resistant(infertile) women with PCOS are mostly associated with IR.MTF treatment is an economic and easily performed method which can be used to improve the ovulation and pregnancy rates.