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医生是否应该给多囊卵巢综合征(PCOS)患者开二甲双胍?

Should physicians prescribe metformin to women with polycystic ovary syndrome PCOS?

机构信息

Service d'endocrinologie pédiatrique, hôpital Saint-Vincent-de-Paul, 82 avenue Denfert-Rochereau, Paris, France.

出版信息

Ann Endocrinol (Paris). 2010 Feb;71(1):25-7. doi: 10.1016/j.ando.2009.12.005. Epub 2010 Jan 15.

Abstract
  1. Metformin is not efficient enough in order to regulate menstrual cycles. 2.Metformin is not efficient enough in order to treat hyperandrogenism. 3. Metformin should not be used as a first-line treatment in order to treat infertility. Clomiphene citrate (CC) is the reference treatment. 4. Metformin in addition to CC is not recommended as a second line treatment, after the failure of CC alone. 5. Metformin should not be used during pregnancy in non diabetic women with PCOS, in order to prevent the risk of gestational diabetes. 6. Metformin should be prescribed to PCOS women when they are diabetic, in order to prevent their cardiovascular risk, after lifestyle modification. 7. Metformin should not be used in PCOS non diabetic women in order to lose weight. Metformin should not be used in order to treat dyslipidemia in women with PCOS. 8. In PCOS women, without diabetes, but with fasting hyperglycemia or carbohydrate intolerance, metformin should be prescribed if: BMI>35.
摘要
  1. 二甲双胍在调节月经周期方面效果不够显著。

  2. 二甲双胍在治疗高雄激素血症方面效果不够显著。

  3. 二甲双胍不应用于治疗不孕的一线治疗。枸橼酸氯米酚(CC)是参考治疗药物。

  4. 二甲双胍联合 CC 不推荐作为 CC 单独治疗失败后的二线治疗。

  5. 患有 PCOS 的非糖尿病孕妇不应使用二甲双胍,以预防妊娠糖尿病的风险。

  6. 对于已经患有糖尿病的 PCOS 女性,在生活方式改变后,应开具二甲双胍以预防心血管风险。

  7. 二甲双胍不应在 PCOS 非糖尿病女性中用于减肥,也不应用于治疗 PCOS 女性的血脂异常。

  8. 在没有糖尿病的 PCOS 女性中,如果 BMI>35,且伴有空腹高血糖或碳水化合物不耐受,应开具二甲双胍。

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