中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2014年
12期
909-913
,共5页
何巧花%徐嘉宁%崔世红%李杭生%张翠莲
何巧花%徐嘉寧%崔世紅%李杭生%張翠蓮
하교화%서가저%최세홍%리항생%장취련
卵巢过度刺激综合征%受精,体外%雌二醇%血管内皮生长因子类%腈类%三唑类%来曲唑
卵巢過度刺激綜閤徵%受精,體外%雌二醇%血管內皮生長因子類%腈類%三唑類%來麯唑
란소과도자격종합정%수정,체외%자이순%혈관내피생장인자류%정류%삼서류%래곡서
Ovarian hyperstimulation syndrome%Fertilization in vitro%Estradiol%Vascular endothelial growth factors%Nitriles%Triazoles%Letrozole
目的 探讨卵巢过度刺激综合征(OHSS)高危患者在取卵后应用来曲唑能否降低早发型OHSS的发生率.方法 选择2012年6月至2013年12月就诊于河南省人民医院OHSS高危且行全胚胎冷冻的176例不孕症患者,随机分为两组,实验组(86例)自取卵日起连续5d口服来曲唑5 mg/d,对照组(90例)予以安慰剂口服.检测两组患者hCG注射日及其后第5、8、10天血清生殖激素(FSH、LH、雌二醇、孕酮)和血管内皮生长因子(VEGF)水平,同时观察两组患者中、重度早发型OHSS的发生率.结果 在hCG注射后第5、8、10天,实验组患者血清雌二醇水平分别为(5 727±2 089)、(1 613±879)、(193±90) pmol/L,对照组分别为(11 826±4 281)、(7 925±3 507)、(1 628±888)pmol/L;实验组VEGF水平分别为(80±14)、(66±11)、(48±7) ng/L,对照组分别为(108±19)、(126±14)、(148±14) ng/L;实验组均明显低于对照组,两组分别比较,差异均有统计学意义(P＜0.01).在hCG注射后第8、10天,实验组患者血清FSH水平分别为(2.1±1.1)和(3.5±1.3) U/L,对照组分别为(0.7±0.3)和(0.7±0.4) U/L;实验组血清LH水平分别为(0.26±0.19)和(0.72±0.60) U/L,对照组分别为(0.11±0.03)和(0.14±0.08) U/L;实验组均高于对照组,两组分别比较,差异均有统计学意义(P＜0.05).实验组中、重度早发型OHSS发生率[2％(2/86)]明显低于对照组[12％(11/90)],两组比较,差异有统计学意义(P＜0.05).结论 对于OHSS高危需行全胚胎冷冻的患者,取卵后在黄体早期连续5d口服来曲唑(5 mg/d),可以降低血清雌二醇和VEGF水平,有助于降低早发型OHSS发生率.
目的 探討卵巢過度刺激綜閤徵(OHSS)高危患者在取卵後應用來麯唑能否降低早髮型OHSS的髮生率.方法 選擇2012年6月至2013年12月就診于河南省人民醫院OHSS高危且行全胚胎冷凍的176例不孕癥患者,隨機分為兩組,實驗組(86例)自取卵日起連續5d口服來麯唑5 mg/d,對照組(90例)予以安慰劑口服.檢測兩組患者hCG註射日及其後第5、8、10天血清生殖激素(FSH、LH、雌二醇、孕酮)和血管內皮生長因子(VEGF)水平,同時觀察兩組患者中、重度早髮型OHSS的髮生率.結果 在hCG註射後第5、8、10天,實驗組患者血清雌二醇水平分彆為(5 727±2 089)、(1 613±879)、(193±90) pmol/L,對照組分彆為(11 826±4 281)、(7 925±3 507)、(1 628±888)pmol/L;實驗組VEGF水平分彆為(80±14)、(66±11)、(48±7) ng/L,對照組分彆為(108±19)、(126±14)、(148±14) ng/L;實驗組均明顯低于對照組,兩組分彆比較,差異均有統計學意義(P＜0.01).在hCG註射後第8、10天,實驗組患者血清FSH水平分彆為(2.1±1.1)和(3.5±1.3) U/L,對照組分彆為(0.7±0.3)和(0.7±0.4) U/L;實驗組血清LH水平分彆為(0.26±0.19)和(0.72±0.60) U/L,對照組分彆為(0.11±0.03)和(0.14±0.08) U/L;實驗組均高于對照組,兩組分彆比較,差異均有統計學意義(P＜0.05).實驗組中、重度早髮型OHSS髮生率[2％(2/86)]明顯低于對照組[12％(11/90)],兩組比較,差異有統計學意義(P＜0.05).結論 對于OHSS高危需行全胚胎冷凍的患者,取卵後在黃體早期連續5d口服來麯唑(5 mg/d),可以降低血清雌二醇和VEGF水平,有助于降低早髮型OHSS髮生率.
목적 탐토란소과도자격종합정(OHSS)고위환자재취란후응용래곡서능부강저조발형OHSS적발생솔.방법 선택2012년6월지2013년12월취진우하남성인민의원OHSS고위차행전배태냉동적176례불잉증환자,수궤분위량조,실험조(86례)자취란일기련속5d구복래곡서5 mg/d,대조조(90례)여이안위제구복.검측량조환자hCG주사일급기후제5、8、10천혈청생식격소(FSH、LH、자이순、잉동)화혈관내피생장인자(VEGF)수평,동시관찰량조환자중、중도조발형OHSS적발생솔.결과 재hCG주사후제5、8、10천,실험조환자혈청자이순수평분별위(5 727±2 089)、(1 613±879)、(193±90) pmol/L,대조조분별위(11 826±4 281)、(7 925±3 507)、(1 628±888)pmol/L;실험조VEGF수평분별위(80±14)、(66±11)、(48±7) ng/L,대조조분별위(108±19)、(126±14)、(148±14) ng/L;실험조균명현저우대조조,량조분별비교,차이균유통계학의의(P＜0.01).재hCG주사후제8、10천,실험조환자혈청FSH수평분별위(2.1±1.1)화(3.5±1.3) U/L,대조조분별위(0.7±0.3)화(0.7±0.4) U/L;실험조혈청LH수평분별위(0.26±0.19)화(0.72±0.60) U/L,대조조분별위(0.11±0.03)화(0.14±0.08) U/L;실험조균고우대조조,량조분별비교,차이균유통계학의의(P＜0.05).실험조중、중도조발형OHSS발생솔[2％(2/86)]명현저우대조조[12％(11/90)],량조비교,차이유통계학의의(P＜0.05).결론 대우OHSS고위수행전배태냉동적환자,취란후재황체조기련속5d구복래곡서(5 mg/d),가이강저혈청자이순화VEGF수평,유조우강저조발형OHSS발생솔.
Objective To investigate the effect of letrozole in decreasing the early-stage ovarian hyperstimulation syndrome (OHSS) occurrence during the luteal phase for patients of OHSS high-risk after oocyte retrieval.Methods A total of 176 high-risk OHSS patients were randomly divided into two groups after oocyte retrieval.Patients in experiment group (n=86) received 5 mg letrozole per day from the retrieval day and last for 5 days.Others in control group (n=90) received placebo.The serum concentration of FSH,LH,estradiol (E2),progesterone (P) and vascular endothelial growth factor (VEGF) from the day of hCG injection to days after injection (5 days,8 days,10 days) were measured.And the incidence of moderate and severe OHSS was observed.Results The concentration of E2 on the indicated days (5 days,8 days,10 days after hCG injection) in experiment group and control group were (5 727±2 089) versus (11 826±4 281) pmol/L,(1 613±879) versus (7 925±3 507) pmol/L,(193±90) versus (1 628±888) pmol/L; the concentration of VEGF on the indicated days in the two groups were (80± 14) versus (108± 19) ng/L,(66± 11) versus (126± 14) ng/L,(48±7) versus (148± 14) ng/L; the concentration of E2 and VEGF were lower than those in control group (all P＜0.01).The FSH concentration in experiment group were (2.1 ± 1.1) and (3.5± 1.3) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.7±0.3) and (0.7±0.4) U/L in control group (P＜0.05); the LH concentration in experiment group were (0.26±0.19) and (0.72±0.60) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.11 ±0.03) and (0.14±0.08) U/L in control group (P＜0.05).The incidence of moderate and severe OHSS was signicantly decreased after letrozole treatment compared with control group [2％ (2/86) versus 12％ (1 1/90),P＜0.05].Conclusion Administration of 5 mg/d letrozole for 5 days during the luteal phase can reduce the E2 and VEGF levels for the high-risk OHSS patients who needed cryopreserve all embryos,and also reduce the occurrence of early OHSS.
