摘要
Abstract
Objective:To analyze the effect of progesterone combined with low-dose metformin in the treatment of polycystic ovary syndrome(PCOS)patients with insulin resistance and threatened abortion.Methods:A total of 180 PCOS patients complicated with insulin resistance threatened abortion were admitted to Hefei Matemal and Child Health Hospital from January 2022 to December 2023.They were randomly divided into two groups,the control group(n=90)and the observation group(n=90).The control group received the treatment of progesterone intramuscular injection,and the observation group received low-dose metformin for oral medication on the basis of the above treatment.The treatment lasted for 3 months.The changes of uterine artery blood flow[including pulse index(PI),resistance index(RI)and peak systolic velosity/end diastolic velosity(S/D)]were evaluated in the two groups.Serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high mobility group protein Bl(HMGB1)and interleukin-17(IL-17)and other inflammatory factors were observed in the two groups after 3 months of treatment.The levels of reproductive hormones[progesterone,specific human chorionic gonadotropin(β-HCG)]and glucose metabolism indexes[glycosylated hemoglobin(HbA1 c),insulin resistance index(HOMA-IR)]were compared between the two groups.After treatment,the patients were followed up,the abortion rate was recorded,and the incidence of adverse pregnancy outcomes was counted.Results:Before treatment,there was no significant differencein the levels of each observation index between the two groups(P＞0.05).After treatment,PI,R1 and S/D,IL-6,TNF-α,HMGB1,IL-17,HbA1c and HOMA-IR in both groups were significantly decreased(P＜0.05),while the levels of progesterone and β-HCG were significantly increased(P＜0.05),and the changes in the observation group were more significant than those in the control group(P＜0.05).There were no significant differences in the abortion rate and the total incidence of abortion between the two groups(P＞0.05).Conclusions:Progesterone combined with low-dose metformin can reduce the inflammatory factors and increase reproductive hormone levels in patients with PCOS,thereby exerting an anti miscarriage effect on PCOS IR threatened miscarriage patients and reducing the incidence of adverse pregnancy outcomes.关键词
多囊卵巢综合征/胰岛素抵抗/先兆流产/黄体酮/二甲双胍Key words
Polycystic ovary syndrome/Insulin resistance/Threatened abortion/Progesterone/Metformin分类
临床医学
