文章摘要
张媛媛,李 丽,袁秀红,李红梅,薛 娟.来曲唑联合GnRH-a对多囊卵巢综合征患者雌激素水平及对排卵质量的影响[J].,2017,17(23):4521-4524
来曲唑联合GnRH-a对多囊卵巢综合征患者雌激素水平及对排卵质量的影响
Effect of Letrozole Combined with GnRH-a on Serum Estrogen Levels and Ovulation Quality of Patients with Polycystic Ovary Syndrome
投稿时间:2016-12-20  修订日期:2017-01-15
DOI:10.13241/j.cnki.pmb.2017.23.028
中文关键词: 来曲唑  醋酸曲普瑞林  多囊卵巢综合征  雌激素  排卵质量
英文关键词: Letrozole  GnRH-a  PCOS  Estrogen  Ovulation quality
基金项目:陕西省教育厅科研计划项目2013JK0782
作者单位
张媛媛 延安大学附属医院 妇产科生殖中心 陕西 延安 716000 
李 丽 延安大学附属医院 产科 陕西 延安 716000 
袁秀红 延安大学附属医院 妇产科生殖中心 陕西 延安 716000 
李红梅 延安大学附属医院 产科 陕西 延安 716000 
薛 娟 延安大学附属医院 妇产科生殖中心 陕西 延安 716000 
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中文摘要:
      摘要 目的:研究来曲唑(Letrozole,LE)联合醋酸曲普瑞林(GnRH-a)治疗多囊卵巢综合征(PCOS)的临床疗效及对排卵质量的影响。方法:选取我院2014年8月到2016年1月收治的PCOS患者112例,随机将其分为对照组(50例)和观察组(62例)。在月经周期第3~7天时,观察组患者口服LE,2.5 mg/d;对照组患者肌肉注射人绝经期促性腺素(HMG),75 IU/d。当最大卵泡直径(MFD)≥18 mm时,观察组患者皮下注射0.1 mg醋酸曲普瑞林诱发排卵,对照组患者肌肉注射6000~10000 IU 人绒毛膜促性腺激素(HCG)诱发排卵。比较两组患者诱发排卵日的排卵效果和血清各激素水平,并统计妊娠结局。结果:诱发排卵日,两组患者的子宫内膜厚度、成熟卵泡数目、血清黄体生成激素(LH)和孕酮(P)水平、排卵率、妊娠率及黄体功能不全发生率比较差异均无统计学意义(P>0.05),观察组的优势卵泡数目、血清E2和T水平、多胎率、OHSS发生率及卵巢囊肿发生率均明显低于对照组(P<0.05)。结论:LE联合GnRH-a可有效提高PCOS患者的排卵质量,降低血清雌激素水平,并能预防OHSS发生,改善妊娠结局。
英文摘要:
      ABSTRACT Objective: To study the clinical effect of letrozole combined with triptorelin acetate (GnRH-a) on the serum estrogen level and ovulation quality of patients with polycystic ovary syndrome(PCOS). Methods: 112 cases of PCOS patients in our hospital from August 2014 to January 2016 were selected and randomly divided into the control group (50 cases) and the observation group (62 cases) according to the wishes of patients. During the first 3~7 days of the menstrual cycle, the patients in the observation group were treated by LE, 2.5 mg/d; the patients in the control group were given intramuscular injection of human menopausal gonadotropin (HMG), 75 IU/d. when the diameter of the largest follicle (MFD)≥18 mm, the patients in the observation group were were given subcutaneous injection of 0.1 mg triptorelin acetate induced ovulation, patients in the control group were given intramuscular injection of Human chorionic go- nadotropin HCG6000~10000IU induced ovulation. The ovulation induced ovulation effect and the serum hormone levels and pregnancy outcome were compared between two groups. Results: On the induced ovulation day, no significant difference was found in the endome- trial thickness, the number of mature follicles, serum LH and P levels, rate of pregnancy and the luteal function between two groups of patients (P>0.05), the number of dominant follicles, serum E2 and T levels, multiple pregnancy rate, the incidence of OHSS and ovarian cyst in observed group were significantly lower than those of the control group (P<0.05). Conclusion: LE combined with GnRH-a could effectively improve the quality of ovulation in patients with PCOS, reduce the serum level of estrogen, and prevent the occurrence of OHSS, improve the outcome of pregnancy.
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