- 期刊
Effects of Metformin on the Uterine and Ovarian Stromal Blood Flow in Women with Polycystic Ovary Syndrome
Metformin對於多囊性卵巢患者子宮及卵巢血流的影響
摘要
目的：評估metformin治療對多囊性卵巢婦女子宮動脈及卵巢基質動脈血流的影響。 材料和方法：總共36位具有多囊性卵巢症候群的患者接受metformin治療三個月，劑量為每次500毫克、每日三次。研究期間有13位患者中斷實驗，最後共23 位婦女於治療前後分別接受經陰道彩色脈衝式都卜勒超音波的評估並偵測其兩側子宮動脈及兩側卵巢基質動脈的血流流速波形，測量並紀錄其脈衝指數（PI）及阻抗指數（RI）並將治療前後的變化作比較分析。同時進一步分析比較於metformin治療期間自然受孕的婦女其治療前後血流的改變情況。 結果：所有患者在治療前及治療後其兩側子宮動脈和兩側卵巢基質動脈的血流脈衝指數（PI）及阻抗指數（RI）的變化並沒有達到統計上的顯著差異“另外在治療中受孕的七位婦女（佔30.4%）相較於其他接受治療而未受孕的婦女，其治療後兩側子宮動脈和兩側卵巢基質動脈的血流阻力變化亦沒有顯著差異。 結論：雖然在某些報告認為metformin可以改善局部血流情形，但在我們的研究中顯示經過mctformin治療後兩側子宮和卵巢的血流動力學變化並沒有明顯差異。另外治療中受孕的婦女其治療前後兩側子宮動脈和兩側卵巢基質動脈的血流脈衝指數（PI）及阻抗指數（RI）的變化也沒有顯著差異，表示metformin對於治療中自然受孕的多囊性卵巢症候群患者也沒有改善其血流動力學的情況。因此，mctformin在治療多囊性卵巢症候群患者的真正機轉仍然是不清楚，而且需要再更進一步的研究探討。
並列摘要
Objective: To investigate the influence of metformin on the uterine and ovarian stromal blood flow in women with polycystic ovary syndrome (PCOS). Material(s) and Method(s): Thirty-six infertile patients with PCOS were included initially. These patients received metformin treatment for three months with a dosage of 500 mg three times daily. During the period of this study, 13 patients dropped out of the study. Finally, 23 cases had undertaken blood flow assessment of bilateral uterine and ovarian stromal arteries before and after 3-month treatment by the conventional transvaginal color Doppler ultrasonography. The pulsatility index (P1) and resistance index (RI) of the bilateral uterine and ovarian stromal arteries were measured. The data before treatment were compared with the ones after treatment. Among them, the pregnant patients were further identified and received another analysis to compare the changes after metformin treatment. Result(s): When comparing the vascular impedance of all the patients before and after metformin treatment, the P1 and RI of the bilateral uterine and ovarian stromal arteries showed no significant differences. In addition, in the seven patients (30.4%) who were pregnant, the vascular impedance of these pregnancy women did not have significant differences while compared with that of these non-pregnancy women who also received metformin treatment. Conclusion(s): Although some previous studies reported that metformin might improve regional blood flow, no significant changes in the vascular impedance of uterine and ovarian flow after metformin treatment can be observed in this study. Besides, no differences in the P1 or RI of the uterine and ovarian arteries were found in the pregnant women after treatment, which implies that metformin may not ameliorate blood flow indexes in PCOS women. However, the underlying effect of metformin to PCOS remains to be solved and further studies are needed.