CAJ | 학술논문

目的：了解多囊卵巢综合征（ polycystic ovary syndrome ，PCOS）患者综合治疗后对其妊娠结局的影响。方法选取2012年8月～2014年2月就诊于首都医科大学附属北京妇产医院内分泌科被确诊为多囊卵巢综合征且有妊娠要求，并自愿签署知情同意书参加本研究项目的妇女共100例。其中根据是否需要、是否愿意服用炔雌醇环丙孕酮片达英-35和二甲双胍，分为研究组50例和对照组50例。研究组进行3个月个体化综合治疗〔达英-35和（或）二甲双胍联合生活方式调整〕。对照组则仅进行生活方式调整，观察2组的妊娠情况。结果研究组与对照组相比，2组的妊娠率比较，差异无统计学意义（ P＞0．05）；对照组自然流产6例，妊娠期糖尿病发生5例，妊娠期高血压发生6例；研究组自然流产3例，无妊娠期糖尿病及妊娠期高血压事件发生。2组的自然流产率比较，差异无统计学意义（P＞0．05），但研究组与对照组相比自然流产率有降低的趋势。研究组的妊娠期糖尿病、妊娠期高血压发生率均低于对照组（ P＜0．05）。结论个体化综合治疗对多囊卵巢综合征患者的妊娠有积极作用，可在一定程度上减少妊娠不良结局（如自然流产、妊娠期糖尿病、妊娠期高血压等）的发生。
목적：료해다낭란소종합정（ polycystic ovary syndrome ，PCOS）환자종합치료후대기임신결국적영향。방법선취2012년8월～2014년2월취진우수도의과대학부속북경부산의원내분비과피학진위다낭란소종합정차유임신요구，병자원첨서지정동의서삼가본연구항목적부녀공100례。기중근거시부수요、시부원의복용결자순배병잉동편체영-35화이갑쌍고，분위연구조50례화대조조50례。연구조진행3개월개체화종합치료〔체영-35화（혹）이갑쌍고연합생활방식조정〕。대조조칙부진행생활방식조정，관찰2조적임신정황。결과연구조여대조조상비，2조적임신솔비교，차이무통계학의의（ P＞0．05）；대조조자연유산6례，임신기당뇨병발생5례，임신기고혈압발생6례；연구조자연유산3례，무임신기당뇨병급임신기고혈압사건발생。2조적자연유산솔비교，차이무통계학의의（P＞0．05），단연구조여대조조상비자연유산솔유강저적추세。연구조적임신기당뇨병、임신기고혈압발생솔균저우대조조（ P＜0．05）。결론개체화종합치료대다낭란소종합정환자적임신유적겁작용，가재일정정도상감소임신불량결국（여자연유산、임신기당뇨병、임신기고혈압등）적발생。
Objective To observe efficacy of comprehensive treatment for polycystic ovary syndrome ( PCOS) on pregnancy outcomes . Methods A total of 100 patients with PCOS who were expecting to become pregnant seen in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University between August 2012 and February 2014 and signed informed consent voluntarily to participate in this research project were enrolled .According to need and willingness of participants to take Diane-35 and metformin , they were divided into observation group ( n=50 ) and control group ( n =50 ) . The patients in observation group were treated with individualized comprehensive treatment for 3 months, which included Diane-35 and/or metformin and modification of lifestyle .Control group was only treated with modification of lifestyle .The pregnancy outcomes of two groups were observed .Results ①The pregnancy rate of 2 groups had no significant difference(P>0.05);②The control group had spontaneous abortion in 6 cases, gestational diabetes mellitus in 5 cases and pregnancy induced hypertension in 6 case; the observation group developed spontaneous abortion in 3 cases and had no gestational diabetes mellitus and pregnancy induced hypertension events .The spontaneous abortion rate for two groups had no significant difference (P>0.05), but compared to control group, observation group had a tendency to have lower rate of spontaneous miscarriege .The incidence of gestational diabetes and pregnancy induced hypertension in observation group were lower than those of control group ( P<0.05).Conclusion Comprehensive treatment showed a positive role in pregnancy of patients with PCOS and can reduce adverse pregnancy outcomes ( e.g.spontaneous abortion , gestational diabetes mellitus , pregnancy induced hypertension ) to a certain extent .