研究二甲双胍对PCOS患者血清AMH及相关代谢指标的影响

发布时间：2018-03-13 07:09

  本文选题：二甲双胍　切入点：多囊卵巢综合征　出处：《皖南医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:检验二甲双胍对PCOS患者的治疗效果,以及血清AMH在治疗过程中的变化;检验二甲双胍在PCOS患者无胰岛素抵抗情况下血清AMH及各项指标的影响,帮助更多的了解二甲双胍治疗PCOS的作用效果,进一步观察多囊卵巢综合征内分泌代谢情况,为临床治疗提供更可靠的依据。方法:选取皖南医学院弋矶山医院生殖中心门诊就诊的多囊卵巢综合征患者,将他们随机分成A、B两组,二甲双胍治疗组(A组)及空白对照组(B组)。在实验前在患者月经第三天检测患者血清AMH值及相关代谢指标并记录,随后进行相关治疗及对照,三个月后的月经第三天复测血清AMH值及相关代谢指标。同时将A组与B组按照有无胰岛素抵抗分为A1、A2组及B1、B2组。最后将各组数据进行统计学分析,得出相关结论。结果:1.实验组(A组)PCOS患者经二甲双胍治疗后,AMH值明显下降,平均下降幅度超过2ng/ml,并有统计学意义(t=8.290,P0.05);同时BMI(t=5.562,P0.05)及T(t=7.248,P0.05)也明显下降,并有统计学意义;而FSH(t=0.750,P0.05)及LH(t=,0.613,P0.05)有轻微波动,但差异无统计学意义。2.对照组(B组)治疗前后AMH有轻微下降,但是差异无统计学意义(t=1.736,P0.05);同时各项指标BMI(t=0.567,P0.05)、FSH(t=-0.444,P0.05)、LH(t=0.827,P0.05)、T(t=0.633,P0.05)均有轻微波动,但无统计学差异差异。3.实验组中有胰岛素抵抗组(A1组)PCOS患者经二甲双胍治疗后,AMH值明显下降,平均下降幅度超过2ng/ml,并有统计学意义(t=5.913,P0.05);同时BMI(t=3.936,P0.05)及T(t=7.177,P0.05)也明显下降,并有统计学意义;而FSH(t=0.651,P0.05)及LH(t=0.500,P0.05)并无统计学差异。4.实验组中无胰岛素抵抗组(A2组)PCOS患者经二甲双胍治疗后,AMH值明显下降,平均下降幅度超过2ng/ml,并有统计学意义(t=5.917,P0.05);同时BMI(t=3.976,P0.05)及T(t=3.198,P0.05)也明显下降,并有统计学意义;而FSH(t=-0.589,P0.05)及LH(t=0.377,P0.05)并无统计学差异。5.实验组(A组)同对照组(B组)比较,实验组(A组)PCOS患者经二甲双胍治疗前后AMH值、BMI、LH、T值的改变幅度更大,AMH(t=-5.189,P0.05)、BMI(t=-3.582,P0.05)、T值(t=-3.046,P0.05)的改变趋势为减小,而LH(t=5.849,P0.05)值的改变趋势为增大,并有统计学意义(P0.05),而FSH(t=-1.809,P0.05)值的改变趋势为减少,但无统计学意义(P0.05)。6.实验组中有胰岛素抵抗组(A1组)同对照组中有胰岛素抵抗组(B1组)比较,实验组中有胰岛素抵抗组(A1组)PCOS患者经二甲双胍治疗前后AMH值、BMI、LH、T值的改变幅度更大,AMH(t=-2.136,P0.05)、BMI(t=-2.983,P0.05)、T值(t=-2.071,P0.05)的改变趋势为减小,而LH(t=3.209,P0.05)值的改变趋势为增大,并有统计学意义(P0.05),而FSH(t=-1.206,P0.05)值的改变趋势为减少,但无统计学意义(P0.05)。7.实验组中无胰岛素抵抗组(A2组)同对照组中无胰岛素抵抗组(B2组)比较,实验组中无胰岛素抵抗组(A2组)PCOS患者经二甲双胍治疗前后AMH值、BMI、LH、T值的改变幅度更大,AMH(t=-4.009,P0.05)、BMI(t=-2.571,P0.05)、T值(t=-3.416,P0.05)的改变趋势为减小,而LH(t=3.140,P0.05)值的改变趋势为增大,并有统计学意义(P0.05),而FSH(t=-0.885,P0.05)值的改变趋势为减少,但无统计学意义(P0.05)。结论:1.二甲双胍可影响PCOS患者血清AMH值,并使之降低;2.二甲双胍不仅可以降低有胰岛素抵抗的PCOS患者血清AMH值,同时可降低无胰岛素抵抗的PCOS患者血AMH值,扩大了二甲双胍的应用范围,增加了PCOS的治疗途径。3.二甲双胍影响PCOS患者血AMH值的变化可能与患者本身BMI、T有关,而与FSH无关,而与LH是否有关,仍待进一步论证。4.PCOS患者AMH与BMI有一定的关系,同时与T也有一定的关系,但仍需大样本试验论证。
[Abstract]:Objective: to test the effect of metformin treatment on PCOS patients, and the changes of serum AMH in the treatment process; test metformin without insulin resistance of serum AMH and other indexes in patients with PCOS, help to learn more about PCOS and the effect of metformin in treatment of polycystic ovary syndrome, further observation of endocrine metabolism, provide more reliable the basis for clinical treatment. Methods: selected outpatients with polycystic ovary reproductive center of Wangnan Medical College yijishan hospital syndrome patients, they were randomly divided into A, B two group, metformin treatment group (A group) and control group (group B). Before the experiment of serum AMH in patients with menstruation third days and the related metabolic indexes and recorded, followed by treatment and control, the third day period of three months after the re measurement of serum AMH level and metabolism index. At the same time A group and B group according to the 鏈夋棤鑳板矝绱犳姷鎶楀垎涓篈1,A2缁勫強B1,B2缁，

本文编号：1605316