CAJ | 학술논문

目的探讨多囊卵巢综合征伴高催乳素血症不孕患者的药物治疗方案、临床疗效及安全性.方法 50例多囊卵巢综合征伴高催乳素血症不孕患者,根据溴隐亭使用的方案不同分为两组,Ⅰ组38例,澳隐亭治疗初始量为5 mg/d,使催乳素水平维持正常后逐渐减少量,至维持量为每天1.25～2.5 mg,治疗3周后,于月经第3～5天加用克罗米芬促排卵,B超监测卵泡生长,若无优势卵泡生长加用尿促激素(HMG)75U/L,直至卵泡直径达18 mm时,改用人绒毛膜促性腺激素(HCG)5 000-10 000 IU,HCG用药第2天及第3天指导同房或行人工授精;Ⅱ组12例,溴隐亭初始量同Ⅰ组,并在开始溴隐亭治疗的同时进行促排卵药物治疗,用法同Ⅰ组.观察两组促排卵药使用量及临床治疗效果.结果 Ⅰ组HMG使用天数(指导同房、人工授精)分别为:(7.0±2.0)d、(8.0±1.0)d,与Ⅱ组的(12.0±2.0)d、(13.0±2.0)d相比较,差异均有统计学意义(均P＜0.05);Ⅰ组妊娠率为42.1%(16/38)高于Ⅱ组的25.0%(3/12)(P＜0.05).结论多囊卵巢综合征伴高催乳素血症不孕患者,采用溴隐亭规范治疗,配合促排卵药物的使用,可以减少促排卵药物使用时间,提高临床妊娠率.
목적 탐토다낭란소종합정반고최유소혈증불잉환자적약물치료방안、림상료효급안전성.방법 50례다낭란소종합정반고최유소혈증불잉환자,근거추은정사용적방안불동분위량조,Ⅰ조38례,오은정치료초시량위5 mg/d,사최유소수평유지정상후축점감소량,지유지량위매천1.25～2.5 mg,치료3주후,우월경제3～5천가용극라미분촉배란,B초감측란포생장,약무우세란포생장가용뇨촉격소(HMG)75U/L,직지란포직경체18 mm시,개용인융모막촉성선격소(HCG)5 000-10 000 IU,HCG용약제2천급제3천지도동방혹행인공수정;Ⅱ조12례,추은정초시량동Ⅰ조,병재개시추은정치료적동시진행촉배란약물치료,용법동Ⅰ조.관찰량조촉배란약사용량급림상치료효과.결과 Ⅰ조HMG사용천수(지도동방、인공수정)분별위:(7.0±2.0)d、(8.0±1.0)d,여Ⅱ조적(12.0±2.0)d、(13.0±2.0)d상비교,차이균유통계학의의(균P＜0.05);Ⅰ조임신솔위42.1%(16/38)고우Ⅱ조적25.0%(3/12)(P＜0.05).결론 다낭란소종합정반고최유소혈증불잉환자,채용추은정규범치료,배합촉배란약물적사용,가이감소촉배란약물사용시간,제고림상임신솔.
Objective To study effect of drug treatment in polycystic ovary syndrome patients with hyperprolactinemia.Methods We retrospectively studied 50 women with polycystic ovary syndrome and hyperprolactinemia from the outpatient between January 2005 and April 2008.Acccording to the beginning time of bmmocriptine.all women were divided into two groups.Groups Ⅰ was composed of 38 cases who received bromocriptine before induction of ovulation cycies,and the dose of bromocriptine was modulated depending on the level of serum prolaotin.When serum prolactin was controlled at normal levels,we decreased the dosage of bromocriptine step by step(1.25mg once),and then continued the treatment at maintenance dosage for no less than 3 weeks.After a baseline ultrasonographic examination on day 3,patients were treated with clomiphene citrate at a dosage of 100mg(2 tablets/day)for 5 days of a normal cycle or progesterone-induced bleeding.On day 9.we monitored the growth conditions of follicles routinely with trails-vagihal ultrasound.If there was no dominant follicle,we added human menopausal hormone(HMG 75U/d)to the protocol.Human chorionic gonadotropin(HCG,5 000-10 000IU)was given intramuscularly when the mean diameter of a follicle reached at least 18mm.At the same time we iustmcted the patients to have sexual intercourses or carried out artificial inseminations before and after ovulation.Group Ⅱ were 12 cases in which induction of ovulations were commenced almost simultaneously with beginning of bromeoriptine.The same protucol was given to patients in group Ⅱ.The procedures of ovulation induction and the outcomes of treatment were analyzed and compared.Results Compared with groupⅡ.the days of using HMG in group Ⅰ was shorter by instructing the time of sexual intercourse.The difference was significant(P=0.004).And there were similar rosults in the artificial insemination cycles(P=0.009).The rate of pregnancy in group Ⅰ(42% 16/38)was higher than that in group Ⅱ(25%,3/12),but the difference was not obvious.Conclusion Bromocriptine administration before the stimulated ovulation therapy can decrease the total dosage and treatment course of ovulating drugs.Induction of ovulations simultaneously with start of bromocriptine therapy can shorten the treatment time of infertility.