国际妇产科学杂志

国际妇产科学杂志 ›› 2010, Vol. 37 ›› Issue (1): 47-49.

• 综述 • 上一篇    下一篇

胰岛素增敏剂治疗多囊卵巢综合征疗效与安全性

付莹;卢实;李红发   

  1. 430000 武汉，华中科技大学同济医学院附属协和医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-02-15 发布日期:2010-02-15
  • 通讯作者: 李红发

Insulin Sensitizing in the Treatment Efficacy and Safety of PCOS

FU Ying;LU Shi;LI Hong-fa   

  1. Department of Obstetrics and Gynecology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000,China Corresponding author: LI Hong-fa, E-mail:apple2010120101@qq.com
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-02-15 Online:2010-02-15
  • Contact: LI Hong-fa

PDF (PC)

4975

摘要： 多囊卵巢综合征（PCOS）导致生殖和代谢功能紊乱的同时也增加罹患2型糖尿病及代谢综合征的危险。认识到胰岛素抵抗在PCOS发病中起到的作用后，以二甲双胍为代表的胰岛素增敏剂在临床广泛应用。最近一个以胎儿活产率（live-birth rate）为终点的随机对照试验（RCT）表明，单用二甲双胍治疗由PCOS引起的不孕症，其效果不及氯米芬。无证据证明应用二甲双胍能防止PCOS的妊娠妇女发生自然流产和妊娠期糖尿病。有研究噻唑烷二酮（TZD）类药物可能会增加心血管事件发生率。长期用药安全性的问题重新引起关注。

关键词: 不孕症, 胰岛素抵抗, 二甲双胍, 多囊卵巢综合征, 噻唑烷二酮

Abstract: Polycystic ovary syndrome （PCOS） causes major metabolic and reproductive morbidities, including substantially increased risk for type 2 diabetes mellitus and the metabolic syndrome. After the recognition that insulin resistance has a pivotal role in PCOS, insulin-sensitizing drugs, specifically metformin, have been widely adopted as therapy for this condition. A recent, large, randomized, clinical trial that assessed live-birth rates suggested that metformin alone is inferior to clomiphene citrate in treating infertility associated with PCOS. Furthermore, there is no evidence to support the use of metformin during pregnancy to prevent spontaneous abortions or gestational diabetes mellitus in women with PCOS. Renewed safety concerns about thiazolidinediones followed recent studies that reported increased cardiovascular events with these agents.

Key words: Infertility, Insulin resistance, Metformin, Polycystic ovary syndrome, Thiazolidinediones