【摘要】 目的:探讨二甲双胍联合经阴道B超卵泡穿刺术治疗耐氯米芬多囊卵巢综合征(poly-cystic ovarian syndrome,PCOS)对胰岛素抵抗、排卵率、妊娠率的影响。方法:66例耐氯米芬PCOS患者,分为二甲双胍口服联合经阴道B超卵泡穿刺术治疗组(联合组,33例)和单纯经阴道B超卵泡穿刺术治疗组(单纯组,33例),观察2组治疗后的排卵率及胰岛素抵抗情况,并随访2组的自然妊娠情况。结果:2组治疗后的排卵率均比治疗前升高(均为P<0·01)。单纯组治疗后胰岛素抵抗情况无明显变化;联合组治疗后胰岛素敏感指数比治疗前及单纯组明显改善(P<0·05),胰岛素抵抗指数降低(P<0·05)。2组排卵率比较差异无统计学意义(P>0·05)。单纯组妊娠率为24%,联合组为39%,2组比较差异有统计学意义(P<0·05)。结论:二甲双胍联合经阴道卵泡穿刺可提高耐药PCOS患者的排卵率,同时能明显改善胰岛素抵抗并提高妊娠率。更多还原

【Abstract】 Objective:To investigate the influence of combined ultrasound-guided follicle puncture technique and metformin on insulin resistance,ovary rate(OR),pregnancy rate in clomifene-resistant polycystic ovarian syndrome(PCOS) women.Methods:Sixty-six women with clomifene-resistant PCOS were divided into two groups.Combined group(n=33) was given combined therapy of oral metformin and ultrasound-guided follicle puncture.Simple group(n=33) was given ultrasound-guided follicle puncture alone.Insulin resistance and ovary rate were investigated after therapy and the normal pregnancy rate was also investigated.Results:The ovulating rates in both groups significantly increased after treatment(P<0.01).There was no significant differences in the index of insulin resistanc between pre-and post-treatment in simple group.The index of insulin saitivity of combined group had significant improvement compared to simple group(P<0.05),while the index of insulin resistance significantly decreased(P<0.05).There was no significant differences in OR between the two groups after treatment(P>0.05).The pregnancy rate(39%)of combined group was significantly higher than that(24%)of simple group(P<0.05).Conclusion:Metformin combined with ultrasound-guided puncture technique can increase OR,improve insulin resistance and increase pregnancy rate in clomifene-resistant PCOS women.更多还原