摘要
目的探讨高胰岛素（ＩＮＳ）血症在多囊卵巢综合征（ＰＣＯＳ）发病中的作用及二甲双胍对ＰＣＯＳ的治疗效果。方法将２３例ＰＣＯＳ病人分为肥胖组（１２例）和非肥胖组（１１例），于服二甲双胍前及服二甲双胍８～１２周后，应用放射免疫法测定基础状态下雄激素、黄体生成素（ＬＨ）、性激素结合球蛋白及促性腺激素释放激素激动剂（ＧｎＲＨａ）刺激后，血１７α羟孕酮（１７ＯＨＰ）和ＬＨ的水平、口服糖耐量试验（ＯＧＴＴ）中血ＩＮＳ水平。结果用药后肥胖组空腹血ＩＮＳ水平和非肥胖组ＯＧＴＴ时血ＩＮＳ反应曲线下面积均明显下降；两组基础状态下的血１７ＯＨＰ、雄烯二酮（Ａ）、睾酮（Ｔ）水平均显著下降、性激素结合蛋白水平显著增加；ＬＨ基值及ＧｎＲＨａ刺激后的ＯＨＰ和ＬＨ值均无明显变化。结论高ＩＮＳ血症在ＰＣＯＳ的高雄激素血症起重要作用。
Objective To investigate the role of insulin in the polycystic ovary syndrome(PCOS) pathogenesis and application of Metformin in the treatment of PCOS. Methods Serum androgen,luteinizing hormone(LH) and sex hormone binding globulin(SHBG) concentration during fasting and serum 17α hydroxyprogesterone (17 OHP), LH level in response to gonadotropin releasing hormone agonist (GnRH a) stimulation were determined. Oral glucose tolerance tests(OGTT) before and after oral administration of metformin for 8～12 weeks were performed in 12 obese and 11 lean women with PCOS. Results After oral administration of metformin for 8～12 weeks, fasting insulin concentration in obese group and area under curve (AUC) after OGTT in lean group decreased significantly. There were significant decrease in basal 17α hydroprogesterone、androstenedione、testosterone concentration, and increase in serum SHBG concentration in obese and lean groups. Basal LH and the response of serum 17 OHP, LH to GnRHa were not significantly changed. Conclusions Hyperinsulinemia may play an important role in hyperandrogenism GnRH a of PCOS, and metformin may be used in the treatment of PCOS.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
1998年第12期731-734,共4页
Chinese Journal of Obstetrics and Gynecology
