【摘要】 目的观察在多囊卵巢综合征(PCOS)并胰岛素抵抗(IR)患者中,二甲双胍与吡格列酮联合应用及吡格列酮单独应用的临床疗效。方法对40例PCOS并IR患者进行前瞻性研究,并选取20例非PCOS不孕妇女为对照组。PCOS组根据BMI分为A、B两组,测定糖、脂代谢指标、生殖激素及C反应蛋白(CRP)等。A组20例(吡格列酮),B组20例(二甲双胍与吡格列酮)。经12周治疗后,再比较上述各指标的变化。结果 PCOS组治疗前胰岛素水平、生殖激素及CRP等均较对照组增高。2组患者治疗后胰岛素抵抗指数、甘油三脂及血清睾酮(T)等均较治疗前明显降低(P<0.05),B组BMI较治疗前明显下降(P<0.05)。应用协方差分析治疗后2组的各指标,2hINS、T在B组下降较A组更明显(P<0.05)。结论二甲双胍与吡格列酮联用治疗PCOS并IR,较单用吡格列酮更有效;慢性炎症反应可能参与PCOS的发生及发展过程,慢性炎症的发生可能是胰岛素敏感性降低的原因之一。更多还原

【Abstract】 【Objective】 To investigate the clinical theraputic effects of pioglitazone and pioglitazone plus metformin in patients of polycystic ovary syndrome(PCOS) with insulin resistance(IR).【Methods】 A prospective study involved total 40 PCOS patients as the examination group and 20 non-PCOS infertility patients as control.PCOS patients were divided into two groups according to BMI: group A(pioglitazone) and group B(pioglitazone plus metformin).Levels of sex hormone,C-reactive protein(CRP) were performed in all patients.After the end of 12-week therapy,above-mentioned parameters were re-evaluate-d.【Results】 PCOS patients had significant increases in levels of blood insulin,sex hormone,CRP comparing with the control group;after the treatment,levels of insulin,IR,triglyceride,testosterone(T) decreased significantly than before in both groups(P <0.05).BMI decreased significantly than before in group B(P <0.05).The levels of BMI,2hINS,T in group B were decreased significantly than group A by the covariance analysis.【Conclusion】 Pioglitazone plus metformin has better effects than pioglitazone mono-therapy;the chronic inflammation may participate in the pathogenesis of PCOS.Chronic inflammation may be one of the reasons to reducing insulin sensitivity.更多还原