摘要
目的:探讨多囊卵巢综合征(PCOS)患者应用口服避孕药和二甲双胍预治疗对促排卵效果的影响。方法:168例PCOS患者治疗前后常规化验内分泌、糖耐量、胰岛素释放实验,计算稳态模型胰岛素抵抗指数(HOMAIR),随机分成三组,A组(对照组)56例:直接用氯米芬促排卵,如未妊娠连用3个月;B组54例:先用口服避孕药(OCP)去氧孕烯炔雌醇(Marvlon)或炔雌醇环丙孕酮(Dain-35)预治疗3个月,然后用氯米芬促排卵;C组58例:同时口服OCP和二甲双胍三个月,然后促排卵。比较三组治疗前后内分泌变化、三周期累积排卵率和妊娠率。结果:B组和C组治疗后睾酮(T)及黄体生成素(LH)水平明显下降,排卵率和妊娠率均高于A组,P<0.05。C组治疗后胰岛素水平及HOMA IR明显降低,差异有显著性意义,P<0.05。结论:PCOS患者应用口服避孕药和二甲双胍预治疗可改善内分泌状态,提高促排卵效果和妊娠率。
Objective ： To investigate the effect of beforehand treatment with oral contraceptive and/ or metformin on stimulation of infertility patients with polycystic ovary syndrome. Methods： One hundred and sixty eight PCOS patients received endometrial tests and oral glucose test （OGTT） and insulin releasing test and homeostasis model assessment insulin resistance （HOMA IR） before and after the treatment. They were randomly divided into three groups. Group A （56 cases） received clomiphene citrate （CC） directly for three months. Group B （54 cases） took oral contraceptive pill （OCP） desogestrel-ethinylestradiol or Diane 35 for three months firstly, then received CC for 3 months. Group C （58 cases） took oral contraceptive pill （OCP） and metformin in combination firstly then recived CC. The levelsof endocrinal hormone, HOMA IR, and ovulation and pregnancy rate were compared among the 3 groups. Results： The testosterone （T） and luteal hormone （LH） levels in serium descended signifcantly after treatment in group B and C. The ovulation rate and pregnancy rate were higher than that in group A （ P 〈 0.05 ）. The insulin level and HOMA IR decreased in group C after the treatment （P 〈 0. 05）. Conclusion ： Beforehand treatment with OCP and metformin to PCOSpatients could improve the endocrinal condition and increase the ovulation and pregnance rate.
出处
《河南医学研究》
CAS
2009年第3期204-206,共3页
Henan Medical Research
关键词
口服避孕药
二甲双胍
多囊卵巢综合征
妊娠率
oral contraceptive
metformin
polycystic ovary syndrome
pregnancy rate
