CAJ | 학술논문

目的：探讨克罗米酚(CC)、来曲唑(LE)以及人绝经期促性腺激素(HMG)3种促排卵方案联合宫腔内人工授精(IUI)的临床妊娠结局。方法选择2011年10月至2012年9月因排卵障碍、多囊卵巢综合征、卵泡发育不良及卵巢储备功能下降等原因在泰州市人民医院接受 IUI 治疗的98例不孕症患者(共计157个治疗周期)为研究对象,并对其临床病历资料进行回顾性分析。按照不同的促排卵药物,将其分别纳入 CC 组(n=36,共计60个治疗周期)、LE 组(n=34,共计55个治疗周期)和 HMG 组(n=28,共计42个治疗周期)。比较3组患者在肌肉注射人绒毛膜促性腺激素(hCG)日的优势卵泡数和大小、注射 hCG 日子宫内膜厚度、临床妊娠率、多胎率、自然流产率及重度卵巢过度刺激综合征发生率等。本研究遵循的程序符合泰州市人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象的知情同意,并与之签署临床研究知情同意书。结果LE 组患者注射 hCG 日子宫内膜厚度显著高于 CC 组和 HMG组,组间比较,差异均有统计学意义(t=-9.329,-6.256；P <0.05),CC 组和 HMG 组患者注射 hCG 日子宫内膜厚度比较,差异无统计学意义(t=1.304,P >0.05)。HMG 组患者在注射 hCG 日优势卵泡数与 CC组和 LE 组比较,差异有统计学意义(t=-1.137,-1.18；P <0.05),而 CC 组和 LE 组患者注射 hCG 日优势卵泡数比较,差异无统计学意义(t =0.704,P >0.05)。结论 LE 在改善子宫内膜厚度上优于 CC 和HMG,而 HMG 在促进卵泡发育方面优于 CC 和 LE。
목적：탐토극라미분(CC)、래곡서(LE)이급인절경기촉성선격소(HMG)3충촉배란방안연합궁강내인공수정(IUI)적림상임신결국。방법선택2011년10월지2012년9월인배란장애、다낭란소종합정、란포발육불량급란소저비공능하강등원인재태주시인민의원접수 IUI 치료적98례불잉증환자(공계157개치료주기)위연구대상,병대기림상병력자료진행회고성분석。안조불동적촉배란약물,장기분별납입 CC 조(n=36,공계60개치료주기)、LE 조(n=34,공계55개치료주기)화 HMG 조(n=28,공계42개치료주기)。비교3조환자재기육주사인융모막촉성선격소(hCG)일적우세란포수화대소、주사 hCG 일자궁내막후도、림상임신솔、다태솔、자연유산솔급중도란소과도자격종합정발생솔등。본연구준순적정서부합태주시인민의원인체시험위원회제정적윤리학표준,득도해위원회비준,분조정득수시대상적지정동의,병여지첨서림상연구지정동의서。결과LE 조환자주사 hCG 일자궁내막후도현저고우 CC 조화 HMG조,조간비교,차이균유통계학의의(t=-9.329,-6.256；P <0.05),CC 조화 HMG 조환자주사 hCG 일자궁내막후도비교,차이무통계학의의(t=1.304,P >0.05)。HMG 조환자재주사 hCG 일우세란포수여 CC조화 LE 조비교,차이유통계학의의(t=-1.137,-1.18；P <0.05),이 CC 조화 LE 조환자주사 hCG 일우세란포수비교,차이무통계학의의(t =0.704,P >0.05)。결론 LE 재개선자궁내막후도상우우 CC 화HMG,이 HMG 재촉진란포발육방면우우 CC 화 LE。
Objective To discuss the clinical pregnancy outcomes of three methods [Clomiphene (CC),Letrozole (LE)and human menopausal gonadotropin (HMG)]of promoting ovulation combining intrauterine insemination (IUI)on infertility.Methods From October 201 1 to September 2012,a total of 98 cases with 1 57 treatment cycles,due to ovulation disorders, polycystic ovary syndrome,follicular dysplasia and other reasons, who were received IUI treatment in Taizhou People′s Hospital were retrospectively analyzed.According to different ovarian simulation potocols,they were incorporated into three groups:CC group (n=36,60 treatment cycles),LE group (n = 34,55 treatment cycles)and HMG group (n=28,42 treatment cycles).There were no significant differences on age and duration of infertility among three groups (P > 0.05 ).The follicle number, size and endometrial thickness on the day of intramuscular injection of human chorionic gonadotropin (hCG),and clinical pregnancy rates,multiple pregnancy rates and abortion rates among three groups were compared.In this study,the procedure followed in line with Taizhou People′s Hospital Ethics Committee to develop a standard human trials to obtain approval of the committee,grouping the consent of the subject′s consent and with the signing of informed consent in clinical research.Results The endometrial thickness on the day of intramuscular injection of hCG of LE group was higher than that of CC group and HMG groups(t=-9.329,P <0.05;t=-6.256,P <0.05),but there was no statistically significant difference between CC group and HMG group (t=1.304,P >0.05).The follicle number of HMG group on the day of intramuscular injection of hCG was much more than that of CC group and LE group (t =-1.137,P <0.05;t =-1.187,P <0.05),while there was no significant difference between CC group and LE group (t =0.704,P >0.05).Conclusions LE was superior to CC and HMG in the aspect of improving endometrial thickness,while HMG was superior to CC and LE in promoting follicle development.