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目的 观察二甲双胍单用或联合高纯度卵泡刺激素(metrodin-HP即FSH-HP)治疗耐克罗米芬(CC)多囊卵巢综合征(PCOS)患者的疗效。方法 选择耐CC的PCOS患者40例,随机分成A组和B组。A组:20例患者从卵泡早期开始服二甲双胍,每天1500mg共12周,若未孕则加FSH-HP促排卵1个周期。B组:20例患者单独用FSH-HP促排卵1个周期。测定所有患者的性激素、空腹血糖(FG)及空腹胰岛素(FINS)。结果 服二甲双胍后,LH、T及FINS的水平明显下降(P<0.05),A组有7例患者排卵且3例妊娠,妊娠率为15.0％。17例未孕者继续服二甲双胍联合FSH-HP促排卵,15例排卵和4例妊娠,妊娠率23.5％。B组单用FSH-HP促排卵,有14例排卵且3例妊娠,妊娠率15.0％。两者的妊娠率差异无显著性意义(P>0.05)。A组的FSH-HP用量少于B组,差异有显著性意义(P<0.05),中度以上0HSS发生率分别为0和10％,前者的发生率低于后者(P<0.05)。结论 单用二甲双胍能使部分患者恢复排卵和妊娠,FSH-HP联合二甲双胍能减少FSH-HP的用量和OHSS的发生。二甲双胍单用或联合FSH-HP促排卵为耐CC的PCOS患者找到一种有效的治疗方法。
Objective To observe the curative effect of metformin alone or combined with high purity follicle stimulating hormone (metrodin-HP, FSH-HP) in the treatment of patients with niacin-resistant polycystic ovary syndrome (PCOS). Methods Forty patients with PCOS resistant to CC were randomly divided into A group and B group. Group A: 20 patients received metformin from the early follicles, 1500mg daily for 12 weeks, if not pregnant plus FSH-HP ovulation 1 cycle. Group B: 20 patients with FSH-HP alone ovulation 1 cycle. All patients were tested for sex hormones, fasting plasma glucose (FG) and fasting insulin (FINS). Results After taking metformin, the levels of LH, T and FINS were significantly decreased (P <0.05). In group A, 7 patients were ovulated and 3 were pregnant, the pregnancy rate was 15.0%. 17 cases of non-pregnant women continue to take metformin combined with FSH-HP ovulation, ovulation in 15 cases and 4 cases of pregnancy, the pregnancy rate was 23.5%. Group B only FSH-HP ovulation, ovulation in 14 cases and 3 cases of pregnancy, pregnancy rate of 15.0%. There was no significant difference between the two pregnancy rates (P> 0.05). The amount of FSH-HP in group A was less than that in group B (P <0.05), and the incidence of 0HSS was 0 and 10% respectively, the former was lower than the latter (P <0.05) . Conclusion Metformin alone can restore ovulation and pregnancy in some patients. FSH-HP combined with metformin can reduce the dosage of FSH-HP and the occurrence of OHSS. Metformin alone or in combination with FSH-HP ovulation-resistant PCOS patients found an effective treatment.