中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
5期
460-462
,共3页
多囊卵巢综合征%青春期%胰岛素抵抗%二甲双胍%糖尿病
多囊卵巢綜閤徵%青春期%胰島素牴抗%二甲雙胍%糖尿病
다낭란소종합정%청춘기%이도소저항%이갑쌍고%당뇨병
Adolescence%Polycystic ovary syndrome%Insulin resistance%Metformin%Diabetes mellitus
目的 探讨青春期多囊卵巢综合征患者应用二甲双胍治疗的效果.方法 35例青春期多囊卵巢综合征患者(其中有糖尿病家族史者7例)均测体质指数(BMI)、基础体温,进行毛发分度标准评分,抽血测定女性激素6项并行75 g葡萄糖耐量试验(OG3T)和胰岛索释放试验.计算稳态模型的胰岛素抵抗指数(HOMA-IR).确诊胰岛素抵抗者口服二甲双胍治疗,定期蕈复检测上述指标.结果 有糖尿病家族史的患者均合并胰岛素抵抗,其与家族糖尿病史阴性者在糖耐量受损发病率分别为85%与19%;毛发分度标准评分为(9.71±3.44)分与(6.43±2.87)分;BMI为(33.78±2.77)kg/m~2与(24.58±4.68)kg/m~2;HOMA-IR为(14.35±4.95)与(4.87±0.79);空腹胰岛素为(51.34±20.51)mU/L与(23.66±9.65)mU/L.负荷后2 h胰岛素(241.55±40.09)mU/L及睾酮值(2.77±0.46)nmoL/L均明显高于家族史阴性患者胰岛素(156.33±46.67)mU/L与睾酮值(1.73±0.33)nmol/L(均P＜0.01).共7例胰岛素抵抗患者接受二甲双胍治疗,24个月后BMI、FG评分、空腹胰岛素、睾酮及促黄体生成素(LH)水平均比治疗前明显降低(均P＜0.05),并全部恢复排卵性月经.结论 糖尿病家族中青春期多囊卵巢综合征患者可能存在较重胰岛素抵抗,坚持包括二甲双胍在内的长期治疗可明显改善胰岛素抵抗,并可恢复卵巢排卵功能.
目的 探討青春期多囊卵巢綜閤徵患者應用二甲雙胍治療的效果.方法 35例青春期多囊卵巢綜閤徵患者(其中有糖尿病傢族史者7例)均測體質指數(BMI)、基礎體溫,進行毛髮分度標準評分,抽血測定女性激素6項併行75 g葡萄糖耐量試驗(OG3T)和胰島索釋放試驗.計算穩態模型的胰島素牴抗指數(HOMA-IR).確診胰島素牴抗者口服二甲雙胍治療,定期蕈複檢測上述指標.結果 有糖尿病傢族史的患者均閤併胰島素牴抗,其與傢族糖尿病史陰性者在糖耐量受損髮病率分彆為85%與19%;毛髮分度標準評分為(9.71±3.44)分與(6.43±2.87)分;BMI為(33.78±2.77)kg/m~2與(24.58±4.68)kg/m~2;HOMA-IR為(14.35±4.95)與(4.87±0.79);空腹胰島素為(51.34±20.51)mU/L與(23.66±9.65)mU/L.負荷後2 h胰島素(241.55±40.09)mU/L及睪酮值(2.77±0.46)nmoL/L均明顯高于傢族史陰性患者胰島素(156.33±46.67)mU/L與睪酮值(1.73±0.33)nmol/L(均P＜0.01).共7例胰島素牴抗患者接受二甲雙胍治療,24箇月後BMI、FG評分、空腹胰島素、睪酮及促黃體生成素(LH)水平均比治療前明顯降低(均P＜0.05),併全部恢複排卵性月經.結論 糖尿病傢族中青春期多囊卵巢綜閤徵患者可能存在較重胰島素牴抗,堅持包括二甲雙胍在內的長期治療可明顯改善胰島素牴抗,併可恢複卵巢排卵功能.
목적 탐토청춘기다낭란소종합정환자응용이갑쌍고치료적효과.방법 35례청춘기다낭란소종합정환자(기중유당뇨병가족사자7례)균측체질지수(BMI)、기출체온,진행모발분도표준평분,추혈측정녀성격소6항병행75 g포도당내량시험(OG3T)화이도색석방시험.계산은태모형적이도소저항지수(HOMA-IR).학진이도소저항자구복이갑쌍고치료,정기심복검측상술지표.결과 유당뇨병가족사적환자균합병이도소저항,기여가족당뇨병사음성자재당내량수손발병솔분별위85%여19%;모발분도표준평분위(9.71±3.44)분여(6.43±2.87)분;BMI위(33.78±2.77)kg/m~2여(24.58±4.68)kg/m~2;HOMA-IR위(14.35±4.95)여(4.87±0.79);공복이도소위(51.34±20.51)mU/L여(23.66±9.65)mU/L.부하후2 h이도소(241.55±40.09)mU/L급고동치(2.77±0.46)nmoL/L균명현고우가족사음성환자이도소(156.33±46.67)mU/L여고동치(1.73±0.33)nmol/L(균P＜0.01).공7례이도소저항환자접수이갑쌍고치료,24개월후BMI、FG평분、공복이도소、고동급촉황체생성소(LH)수평균비치료전명현강저(균P＜0.05),병전부회복배란성월경.결론 당뇨병가족중청춘기다낭란소종합정환자가능존재교중이도소저항,견지포괄이갑쌍고재내적장기치료가명현개선이도소저항,병가회복란소배란공능.
Objective To investigate the clinical effects of long-term mefformin treatment of adolescent polycystic ovary syndrome(PCOS).Methods Among 35 adolescent PCOS women,7 had diabetic family history.Body mass index (BMI),basal body temperature (BBT),sex hormone concentration,75 g oral glucose tolerance tests (OGTT) and insulin release tests (IRT) were tested in all cases.Homeostatic model assessment insulin resistance index(HOMA-IR) were calculated.Patients with insulin resistance(IR) received mefformin therapy.Most tests above-mentioned were repeated at certain time.Results Seven patients with diabetic family history all suffered from IR and had higher Ferriman-Gallway(FG) points,BMI,HOMA-IR,fasting insulin(I0),2 h insulin(I120),T level and incidence of Impaired glucose tolerance(IGT) than those without diabetic family history (P＜0.01).Among 7 cases receiving the mefformin therapy,their BMI,FG points,fasting insulin(I0) concentration,T and LH level decreased significantly after 24 months treatment(P＜0.05),and all cases resumed their ovulation.Conclusions Adolescent PCOS women may all have severe IR and can be treated the long-term mefformin therapy.
