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目的：探讨二甲双胍对多囊卵巢综合征肥胖型患者血清中胰岛素、LH 和FSH 水平的影响。方法：将84 例PCOS 肥胖型患者随机分成44 例对照组（克罗米芬）和40 例观察组（二甲双胍），采用放射免疫法测定黄体生成素（LH）和卵泡刺激素（FSH）的水平，分别于服药前(0 分钟) 和服后60、120 分钟经前臂静脉采血, 测血糖浓度及血清胰岛素水平。结果：对照组患者治疗前 0min、60min 及120min 的血糖OGTT 分别为（4.57±0.25）mmol/L、（8.38±7.05）mmol/L 及（7.21±0.12）mmol/L，治疗后0min、60min 及120min 的血糖OGTT 无明显变化。观察组患者治疗前0min、60min 及120min 的血糖OGTT 分别为（4.11±0.31）mmol/L、（8.23±6.57）mmol/L 及（7.25±0.13）mmol/L，治疗后0min、60min 及120min 的血糖OGTT 明显降低。对照组患者治疗前血清中胰岛素为（47.32±9.52）U /m l，治疗后为（42.25±7.65）U /ml，治疗前后无明显差异。观察组患者治疗前血清中胰岛素为（46.41±6.11） U /ml，治疗后血清胰岛素水平明显降低。对照组患者治疗后血清中LH 为（17.22±2.14）mU /ml，FSH 为（1.24±0.33）mU /m l，而与对照组相比，观察组患者血清中的LH 明显降低，而FSH 水平升高。结论：二甲双胍导致多囊卵巢综合征患者血清中胰岛素水平降低，从而减轻了胰岛素对LH 的刺激作用,使LH 水平下降，FSH 升高，进而改善机体的激素紊乱，最终达到治疗PCOS 的目的。

英文摘要:

Objective: To study the effect of metformin on the LH and FSH levels in obese patients with polycystic ovary syndrome (PCOS). Methods: A total of 84 obese patients with PCOS were randomly divided into two groups: 44 cases in control group (clomiphene citrate) and 40 cases in observation group (metformin). The radioimmunoassay was used to detect the levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Blood were collected respectively before treatment (0 min) and 60, 120 minutes after taking medication via the forearm vein to measure the blood glucose and serum insulin levels. Results: In the control group, OGTT glucose level of patients at 0 min, 60min and 120min before treatment were (4.57±0.25) mmol/L, (8.38±7.05) mmol/L and (7.21±0.12) mmol/L, respectively; there were no significant changes of OGTT blood glucose levels of patients at 0min, 60min and 120min after treatment. In the observation group, the OGTT glucose level of patients at 0min, 60min and 120min before treatment were respectively (4.11±0.31) mmol/L, (8.23±6.57) mmol/L and (7.25±0.13) mmo l/L; but the OGTT blood glucose level decreased significantly at 0min, 60min and 120min after treatment. In the control group, serum insulin was (47.32±9.52) U/ml in patients before treatment, and (42.25± 7.65) U / ml in patients after treatment, with no significant difference before and after treatment. In the observation group, the serum insulin in patients before treatment was (46.41±6.11) U / ml, and was significantly decreased after treatment. After treatment, the serum LH of patients in control group was (17.22 ±2.14) mU / ml, and their FSH was (1.24±0.33) mU/ml. Compared with the control group, the serum LH of patients in the observation group was significantly decreased, but the FSH levels increased. Conclusion: By reducing the level of serum insulin in the polycystic ovary syndrome patients, Metformin could reduce the stimulating effect of insulin on LH, making the LH levels decreased but FSH increased, and then improve the body's hormonal disorders , so as to achieve the purpose of treatment of PCOS.

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