子宫内膜息肉伴胰岛素抵抗患者应用二甲双胍治疗后的疗效分析

发布时间：2018-03-17 15:27

本文选题：子宫内膜息肉　切入点：二甲双胍　出处：《中国妇产科临床杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的分析子宫内膜息肉伴胰岛素抵抗患者的临床及内分泌代谢特征,探讨二甲双胍对于治疗子宫内膜息肉伴胰岛素抵抗患者的临床疗效。方法选取伴胰岛素抵抗并经宫腔镜检查病理证实为子宫内膜息肉患者112例,患者知情同意并选择术后处理方式,56例于术后给予二甲双胍片(二甲双胍组)6个月,其中单发性息肉40例,多发性息肉16例;56例不给予任何处理(对照组),其中单发性息肉42例,多发性息肉14例,观察两组患者随访2年后胰岛素抵抗改善状况及子宫内膜息肉复发。结果 112例患者手术均顺利实施,二甲双胍组体质指数(BMI)、腰围/臀围比(WHR)、空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)与对照组比较均降低(P0.05);二甲双胍组子宫内膜厚度[(8.37±1.41)mm]与对照组[(11.45±0.61)mm]比较,差异有统计学意义(P0.05)。二甲双胍组术后随访(1.44±0.47)年,对照组术后随访(1.49±0.46)年,差异无统计学意义(P0.05)。二甲双胍组术后2年多发性子宫内膜息肉复发2例,复发率3.57%,对照组术后复发20例,复发率35.71%,其中单发息肉7例,多发息肉13例,两者比较,差异有统计学意义(P0.05)。结论子宫内膜息肉伴胰岛素抵抗患者宫腔镜术后服用二甲双胍可能有助于改善其胰岛素抵抗现象,并有助于预防子宫内膜息肉的复发。
[Abstract]:Objective to analyze the clinical and endocrine characteristics of endometrial polyps with insulin resistance. To investigate the clinical efficacy of metformin in the treatment of endometrial polyps with insulin resistance methods 112 cases of endometrial polyps confirmed by hysteroscopy and pathology were selected. 56 patients were given metformin tablets (metformin group) for 6 months, including 40 patients with single polyps. 16 cases of multiple polyps were treated without any treatment (control group: 42 cases of single polyps, 14 cases of multiple polyps). The improvement of insulin resistance and the recurrence of endometrial polyps were observed after 2 years follow-up. Body mass index (BMI), waist circumference / hip circumference ratio (WHRN), fasting insulin FINS (FINS) and insulin resistance index (HOMA-IRR) in metformin group were significantly lower than those in control group (P 0.05), and endometrial thickness in metformin group [8.37 卤1.41 mm] was significantly lower than that in control group [11.45 卤0.61mm]. The difference was statistically significant (P 0.05). The follow-up of metformin group was 1.44 卤0.47 years, and that of control group was 1.49 卤0.46 years. There was no significant difference between the two groups. The recurrence rate of multiple endometrial polyps in metformin group was 3.57 years, and that in control group was 20 cases. The recurrence rate was 35.71%, including 7 cases of single polyps and 13 cases of multiple polyps. The difference was statistically significant (P 0.05). Conclusion Metformin may help improve insulin resistance in patients with endometrial polyps with insulin resistance after hysteroscopy. It also helps to prevent the recurrence of endometrial polyps.
【作者单位】：郑州大学第三附属医院妇产科;
【基金】：河南省教育厅项目(12A320047)
【分类号】：R711.74

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