CAJ | 학술논문

[目的]经阴道彩色超声多普勒评估来曲唑促排卵对多囊卵巢综合征(PCOS)患者子宫内膜容受性的影响.[方法]60例 PCOS 排卵障碍患者,随机分为两组,分别予来曲唑2.5~5 mg(LE 组)和克罗米芬50~100 mg(CC 组)诱发排卵,适时指导同房.于注射人绒毛膜促性腺激素(HCG)日由专人经阴道彩色超声检查,监测子宫内膜厚度、形态、血流变化作为评估子宫内膜容受性的评价指标,观察来曲唑促排卵治疗后对子宫内膜容受性的影响,同时追踪观察其临床结局.[结果]两组患者年龄、不孕年限,体重指数等基本情况无显著性差异. LE 组成熟卵泡数明显少于 CC 组( P <0.05),HCG 注射日 E2水平明显低于 CC 组( P <0.01)而内膜厚度明显大于 CC 组( P <0.01)、A 型血流内膜多于 CC 组(52.38% vs 32.50%)而 C 型血流内膜少于 CC 组( P <0.05),子宫及子宫内膜(下)动脉阻力指数(RI),搏动指数(PI )、血流收缩期最高血流速度(S)/舒张期末血流速度(D)均小于 CC 组.来曲唑组临床妊娠率显著高于 CC 组( P <0.05)而流产率显著低于 CC 组( P <0.05).[结论]在 PCOS 患者促排卵治疗中来曲唑可改善子宫内膜容受性,其临床结局优于克罗米芬,经阴道彩色超声是监测子宫内膜容受性有效、无创的方法.
[목적]경음도채색초성다보륵평고래곡서촉배란대다낭란소종합정(PCOS)환자자궁내막용수성적영향.[방법]60례 PCOS 배란장애환자,수궤분위량조,분별여래곡서2.5~5 mg(LE 조)화극라미분50~100 mg(CC 조)유발배란,괄시지도동방.우주사인융모막촉성선격소(HCG)일유전인경음도채색초성검사,감측자궁내막후도、형태、혈류변화작위평고자궁내막용수성적평개지표,관찰래곡서촉배란치료후대자궁내막용수성적영향,동시추종관찰기림상결국.[결과]량조환자년령、불잉년한,체중지수등기본정황무현저성차이. LE 조성숙란포수명현소우 CC 조( P <0.05),HCG 주사일 E2수평명현저우 CC 조( P <0.01)이내막후도명현대우 CC 조( P <0.01)、A 형혈류내막다우 CC 조(52.38% vs 32.50%)이 C 형혈류내막소우 CC 조( P <0.05),자궁급자궁내막(하)동맥조력지수(RI),박동지수(PI )、혈류수축기최고혈류속도(S)/서장기말혈류속도(D)균소우 CC 조.래곡서조림상임신솔현저고우 CC 조( P <0.05)이유산솔현저저우 CC 조( P <0.05).[결론]재 PCOS 환자촉배란치료중래곡서가개선자궁내막용수성,기림상결국우우극라미분,경음도채색초성시감측자궁내막용수성유효、무창적방법.
Objective]To evaluate the effect of letrozole for the induction of ovulation on endometrial receptivity of PCOS patients by transvaginal color Doppler sonography .[Methods]Sixty polycystic ovarian syndrome (PCOS) patients were randomized into two groups .The patients in 2 groups were given letrozole 2 .5 ~ 5mg(LE group) or chloramiphene citrate(CC) 50 ~ 100mg(CC group) for the induction of ovulation .Sleep together was guided in time .Transvaginal color Doppler sonography was performed by special doctor on the day of HCG administration .The thickness and shape of endometrium and blood flow change were monitored to be used as the indicators for evaluating endometrial receptivity .The effect of letrozole for the induction of ovulation on endometrial receptivity was ob ‐served .Meanwhile clinical outcomes were followed up .[Results]There was no significant difference in age ,infertility time and body mass index between 2 groups .The number of mature follicles in LE group was obviously less than that in CC group ( P < 0 .05) .Ser‐um estradiol(E2) level on HCG day in LE group was obviously lower than that in CC group ( P < 0 .01) ,while the endometrial thick‐ness in LE group was obviously higher than that in CC group ( P < 0 .01) .The endometrium with type‐A flow in LE group was more than that in CC group(52 .38% vs 32 .50% ) ,while the endometrium with type‐C flow in LE group was less than that in CC group ( P< 0 .05) .Resistance index(RI) ,pulsation index(PI) and systolic peak flow rate(S)/diastolic peak flow rate(D) of uterine artery and sub‐endometrial artery in LE group were less than those in CC group .The clinical pregnancy rate in LE group was significantly higher than that in CC group( P < 0 .05) ,while the abortion rate in LE group was significantly lower than that in CC group ( P < 0 .05) .[Conclusion]Letrozole for the induction of ovulation can improve the endometrial receptivity in PCOS patients .The clinical outcomes of letrozole were superior to clomiphene citrate .Transvaginal color Doppler sonography is an effective ,noninvasive and simple and nonin‐vasive approach to evaluate the endometrial receptivity .