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目的探讨使用二甲双胍治疗多囊卵巢综合征(PCOS)对患者颈动脉内中膜厚度(IMT)的影响。方法 33例多囊卵巢综合征患者使用二甲双胍1500mg/d,治疗18个月,比较治疗前后体质指数(BMI)、腰臀比(WHR)、血脂谱、血糖、胰岛素、胰岛素抵抗指标、性激素及颈动脉IMT变化。结果经18个月的二甲双胍治疗,33例PCOS患者的BMI、舒张压(DBP)、睾酮(T)、黄体生成素(LH)、总胆固醇(TC)、空腹胰岛素、稳态模型胰岛素抵抗指数、胰岛素曲线下面积(AUCINS)、血糖曲线下面积和胰岛素曲线下面积比值(AUCGLU/AUCINS)较治疗前显著下降,平均颈动脉IMT减少0.11mm,差异均有统计学意义(P<0.05,P<0.01)。以颈动脉IMT治疗前后差值作为因变量进行多元线性回归分析,治疗前后BMI及HOMA-IR差值进入方程,R2值分别为0.43和0.59。结论 PCOS患者长期使用二甲双胍治疗可减轻体重,改善胰岛素抵抗,并可能减少动脉粥样硬化的发生、发展。
Objective To investigate the effect of metformin on carotid intima-media thickness (IMT) in patients with polycystic ovary syndrome (PCOS). Methods 33 patients with PCOS were treated with metformin 1500mg / d for 18 months. The body mass index (BMI), WHR, blood lipid profile, blood glucose, insulin, insulin resistance, sex hormone and neck Arterial IMT changes. Results After 18 months of metformin treatment, BMI, DBP, T, LH, TC, fasting insulin, insulin resistance index, The area under the curve of insulin (AUCINS), the area under the curve of blood glucose and the area under the curve of insulin (AUCGLU / AUCINS) were significantly lower than those before treatment, and the mean carotid IMT was decreased by 0.11mm (P <0.05, P < 0.01). Multivariate linear regression analysis was performed using the difference before and after carotid IMT as a dependent variable. The difference between BMI and HOMA-IR before and after treatment entered the equation with R2 values of 0.43 and 0.59, respectively. Conclusion Long-term use of metformin in PCOS patients can reduce body weight, improve insulin resistance, and may reduce the occurrence and development of atherosclerosis.