中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
2期
162-165
,共4页
妊娠%不育,女(雌)性%排卵监测%月经周期%内源性黄体生成素峰
妊娠%不育,女(雌)性%排卵鑑測%月經週期%內源性黃體生成素峰
임신%불육,녀(자)성%배란감측%월경주기%내원성황체생성소봉
Pregnancy%Infertility,female%Ovulation detection%Menstrual cycle%Premature LH surge
目的：探讨不孕症妇女自然周期卵泡发育过程中，过早内源性黄体生成素（LH）峰与排卵障碍的相关性，为不孕症妇女行自然周期的辅助生殖技术（ART）治疗提供依据。方法选择2010年1月—2012年1月衢州市妇幼保健院生殖中心不孕症门诊确诊的102例不孕症患者为研究对象，通过尿 LH 半定量检测试纸结合阴道超声，检测出102例不孕症妇女共244个自然周期的卵泡生长、内源性 LH 峰值及落峰时间、排卵情况，依据检测结果分为尿 LH 峰阳性组、尿 LH 峰阴性组及过早 LH 峰组，比较3组的排卵率、未破裂黄素化卵泡（LUF）发生率、周期妊娠率。结果尿 LH 峰阳性组138个，尿 LH 峰阴性组44个，过早 LH 峰组62个。244个自然周期总排卵率为77.0％（188个周期），LUF 发生率为21.3％（52个周期），周期妊娠率为20.9％（51个周期妊娠）。尿 LH 峰阳性组、尿 LH 峰阴性组及过早 LH 峰组的排卵率分别为91.3％、63.6％、54.8％，LUF 发生率分别为8.7％、31.8％、41.9％，周期妊娠率分别为29.0％、11.4％、9.7％；其中尿 LH 峰阳性组的排卵率、周期妊娠率均高于尿 LH 峰阴性组和过早 LH 峰组（P ＜0.05），尿 LH 峰阳性组 LUF 发生率低于尿 LH 峰阴性组和过早 LH 峰组（P ＜0.05），尿 LH 峰阴性组和过早 LH 峰组的排卵率、周期妊娠率、LUF 发生率比较，差异均无统计学意义（P ＞0.05）。结论自然周期卵泡发育过程中容易出现过早的内源性 LH 峰，是导致排卵障碍影响妊娠率的重要因素。临床实践中过早内源性 LH 峰的出现，可预测提早排卵及黄素化卵泡不破裂综合征（LUFS）的发生，可适时注射人绒毛膜促性腺激素，加强黄体支持，以降低 LUFS 的发生，提高临床妊娠率。
目的：探討不孕癥婦女自然週期卵泡髮育過程中，過早內源性黃體生成素（LH）峰與排卵障礙的相關性，為不孕癥婦女行自然週期的輔助生殖技術（ART）治療提供依據。方法選擇2010年1月—2012年1月衢州市婦幼保健院生殖中心不孕癥門診確診的102例不孕癥患者為研究對象，通過尿 LH 半定量檢測試紙結閤陰道超聲，檢測齣102例不孕癥婦女共244箇自然週期的卵泡生長、內源性 LH 峰值及落峰時間、排卵情況，依據檢測結果分為尿 LH 峰暘性組、尿 LH 峰陰性組及過早 LH 峰組，比較3組的排卵率、未破裂黃素化卵泡（LUF）髮生率、週期妊娠率。結果尿 LH 峰暘性組138箇，尿 LH 峰陰性組44箇，過早 LH 峰組62箇。244箇自然週期總排卵率為77.0％（188箇週期），LUF 髮生率為21.3％（52箇週期），週期妊娠率為20.9％（51箇週期妊娠）。尿 LH 峰暘性組、尿 LH 峰陰性組及過早 LH 峰組的排卵率分彆為91.3％、63.6％、54.8％，LUF 髮生率分彆為8.7％、31.8％、41.9％，週期妊娠率分彆為29.0％、11.4％、9.7％；其中尿 LH 峰暘性組的排卵率、週期妊娠率均高于尿 LH 峰陰性組和過早 LH 峰組（P ＜0.05），尿 LH 峰暘性組 LUF 髮生率低于尿 LH 峰陰性組和過早 LH 峰組（P ＜0.05），尿 LH 峰陰性組和過早 LH 峰組的排卵率、週期妊娠率、LUF 髮生率比較，差異均無統計學意義（P ＞0.05）。結論自然週期卵泡髮育過程中容易齣現過早的內源性 LH 峰，是導緻排卵障礙影響妊娠率的重要因素。臨床實踐中過早內源性 LH 峰的齣現，可預測提早排卵及黃素化卵泡不破裂綜閤徵（LUFS）的髮生，可適時註射人絨毛膜促性腺激素，加彊黃體支持，以降低 LUFS 的髮生，提高臨床妊娠率。
목적：탐토불잉증부녀자연주기란포발육과정중，과조내원성황체생성소（LH）봉여배란장애적상관성，위불잉증부녀행자연주기적보조생식기술（ART）치료제공의거。방법선택2010년1월—2012년1월구주시부유보건원생식중심불잉증문진학진적102례불잉증환자위연구대상，통과뇨 LH 반정량검측시지결합음도초성，검측출102례불잉증부녀공244개자연주기적란포생장、내원성 LH 봉치급락봉시간、배란정황，의거검측결과분위뇨 LH 봉양성조、뇨 LH 봉음성조급과조 LH 봉조，비교3조적배란솔、미파렬황소화란포（LUF）발생솔、주기임신솔。결과뇨 LH 봉양성조138개，뇨 LH 봉음성조44개，과조 LH 봉조62개。244개자연주기총배란솔위77.0％（188개주기），LUF 발생솔위21.3％（52개주기），주기임신솔위20.9％（51개주기임신）。뇨 LH 봉양성조、뇨 LH 봉음성조급과조 LH 봉조적배란솔분별위91.3％、63.6％、54.8％，LUF 발생솔분별위8.7％、31.8％、41.9％，주기임신솔분별위29.0％、11.4％、9.7％；기중뇨 LH 봉양성조적배란솔、주기임신솔균고우뇨 LH 봉음성조화과조 LH 봉조（P ＜0.05），뇨 LH 봉양성조 LUF 발생솔저우뇨 LH 봉음성조화과조 LH 봉조（P ＜0.05），뇨 LH 봉음성조화과조 LH 봉조적배란솔、주기임신솔、LUF 발생솔비교，차이균무통계학의의（P ＞0.05）。결론자연주기란포발육과정중용역출현과조적내원성 LH 봉，시도치배란장애영향임신솔적중요인소。림상실천중과조내원성 LH 봉적출현，가예측제조배란급황소화란포불파렬종합정（LUFS）적발생，가괄시주사인융모막촉성선격소，가강황체지지，이강저 LUFS 적발생，제고림상임신솔。
Objective To discuss the correlation between premature luteinizing hormone( LH)surge and ovulatory dysfunction in natural cycle for infertility women in the process of follicular development,and provide therapy basis for ART of nature cycle in infertility women. Methods 102 cases of infertility women were selected from the patients in Reproductive Center of Quzhou Maternal and Child Health - Care Center during the period from jan. 2010 to jan. 2012. Through the semi -quantitative urinary LH testing( uLH) combined with ultrasound,ovulate of 244 nature cycles in 102 infertility women, spontaneous LH surge value and fall surge time,follicular development were detected. This study divided the results into LH surge positive group,negative group and premature LH surge group. Ovulation rate,LUF rate and the pregnancy rate were compared among three groups. Results 138 cases,44 cases and 62 cases were divided into urinary LH surge positive group, negative group and premature LH surge group separately. Ovulation rate in 244 cycles was 77. 0%(118 cycles),the occurrence rate of LUF was 21. 3% (52 cycles),cycle pregnancy rate was 20. 9% (51 cycles). The ovulation rate,LUF rate,and pregnancy rate in three groups were 91. 3% , 63. 6% , 4. 8% ; 8. 7% , 31. 8% , 41. 9% ; 29. 0% , 11. 4% , 9. 7%respectively. The ovulation rate and cycle pregnancy rate in urinary LH surge positive group were higher than those in other two groups(P < 0. 05),while the occurrence rate of LUF was lower than that in other two groups( P < 0. 05). There was no difference between negative group and premature LH surge group(P > 0. 05). Conclusion Premature LH surge is easy to occur in the course of follicular development in natural cycle,which is the important factor of ovulatory dysfunction resulting low pregnancy rate in natural cycle. In clinical,the occurrence of premature LH surge can forecast the premature ovulate and the occurrence of LUFS. Injection of HCG in proper time and enhancing of luteal phase support can reduce the occurrence rate of LUF and improve the clinical pregnancy rate.
