二甲双胍联合盐酸吡格列酮对肥胖型多囊卵巢综合征患者胰岛素抵抗.PDFVIP

二甲双胍联合盐酸吡格列酮对肥胖型多囊卵巢综合征患者胰岛素抵抗的影响研 究 毛爱珺 马昌军 马丁 (四川省巴中市中心医院内分泌科 巴中 636000) 摘要 目的：探讨二甲双胍联合盐酸吡格列酮对肥胖型多囊卵巢综合征（PCOS ）患者 胰岛素抵抗的影响。方法：选择2013年6月至2015年6月收治的71例PCOS患者作 为研究对象，根据体重指数（BMI ）分为非肥胖组（n=34 ）和肥胖组（n=37 ） ，两组患者均给予联合盐酸吡格列酮口服治疗3个月。比较两组患者治疗前、后 BMI 、腰臀比（WHR ）、空腹血糖（FPG ）、空腹胰岛素（FINS ）、胰岛素抵 抗指数（HOMA- IR ）、性激素、卵泡等指标变化情况。结果：治疗前，肥胖组BMI 、WHR 、FP G、FINS 、 HOMA- IR及卵泡数目均明显高于非肥胖组（均P ＜0.05 ）；治疗3个月后，肥胖组BMI 、FPG 、FINS 、HOMA- IR均高于非肥胖组（均P ＜0.05 ）；两组患者游离睾酮（FT ）、卵巢面积、卵泡 数目显著低于治疗前（均P ＜0.05 ），肥胖组FT治疗差值明显高于非肥胖组（P ＜0.05 ）。结论：二甲双胍联合盐酸吡格列酮可减少PCOS患者的游离睾酮和B MI ，改善卵巢多囊样变化及胰岛素抵抗，且对肥胖型PCOS患者的改善效果更 佳明显。 关键词 肥胖症；多囊卵巢综合征；二甲双胍；盐酸吡格列酮；胰岛素抵抗 中图分类号： 文献标志码：A 文章编号： Effect of metformin and Pioglitazone on insulin resistance in obese patients with type PCOS Abstract Objective ：To investigate the effect of metformin and pioglitazone on 收稿日期：2016-03-07 insulin resistance in obese patients with type polycystic ovary syndrome(PCOS).Methods ：71 cases of PCOS patients in our hospital from June 2013 to June 2015 were selected as the object of study,according to body mass index (BMI) were divided into non obesity group (n=34) and obesity group (n=37),two groups of patients were trested with metformin and pioglitazone for 3 months.The blood glucose, BMI, insulin resistance index (HOMA-IR), sex hormone, changes of follicle index were compared between the two groups before and after treatment.Results Before the treatment,the obese group BMI, waist hip ratio (WHR), fasting blood glucose (FPG), fasting insulin (FINS),HOMA-IR and follicle number was significantly higher than that in the non obese group (P 0.05);After 3 months of treatment,the obese group BMI, FPG, FINS, HOMA-IR are higher than the non obese group (P0.05);Two groups of