- 期刊
胰島素敏感化藥物治療多囊性卵巢症候群
Insulin Sensitizing Treatment for Polycystic Ovarian Syndrome
摘要
多囊性卵巢症的臨床症狀為不規則月經、男性激素過高、LH/FSH比率升高、超音波下多囊性卵巢、胰島素抵抗性。大約75%的多囊性卵巢患者患有胰島素抵抗性。胰島素抗性會引起血中胰島素濃度升高，從而引起多囊性卵巢症候群。因此，如何降低血中胰島素成為治療多囊性卵巢症的重要的課題。胰島素敏感化藥物已被證明能有效地治療多囊性卵巢症及其相關疾病，Biguanide類藥物的Metformin則是目前於世界上唯一被廣泛使用的胰島素敏感化藥物。Metformin已被證明能增進排卵、增加懷孕率，且能促增胚胎著床及減少流產比率。長期使用可以預防糖尿病發生。Thiazolidinedione藥物的Troglitazone則因肝毒性太強而下市，Rosiglitazon及Pioglitazone，兩種Thiazolidinedione類藥物較不具肝毒性，但仍須每二個月測驗肝功能，因此限制了此類藥品在生殖內分泌治療的使用。
並列摘要
The clinical diagnosis of polycystic ovarian syndrome is according to the manifestations: irregular menstruation, hyperandrogenism, raised LH/FSH ratio, polycystic ovary and insulin resistance. 75% of women with polycystic ovarian syndrome are with insulin resistance. Insulin resistance may raise the insulin level in blood and cause polycystic ovarian syndrome consequently. Thus, it is mandatory for women with polycystic ovarian syndrome to treat hyperinsulinemia if it exists. Metformin, a biaguanide, is worldwide used to treat hyperinsulinemia in polycystic ovarian syndrome. Metformin is proved to enhance ovulation, increase pregnancy rate, improves embryo implantation, prevent abortion for women with polycystic ovarian syndrome. A long term use of metformin also can prevent diabetes mellitus. Troglitazone, a thiazolidinedione, has been withdrawn for medical use due to severe hepatoxicity. Rosiglitazon and pioglitazone, another two thiazolidinediones, are also limited in use for reproductive medicine due to their mild hepatic toxicity.