中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
12期
1801-1805
,共5页
多囊卵巢综合征%来曲唑%克罗米芬%不孕症
多囊卵巢綜閤徵%來麯唑%剋囉米芬%不孕癥
다낭란소종합정%래곡서%극라미분%불잉증
Polycystic ovary syndrome%Letrozole%Clomiphene citrate%Infertility
目的 比较来曲唑和克罗米芬对多囊卵巢综合征(PCOS)致不孕患者诱发排卵的临床效果及妊娠结局.方法 将67例PCOS致不孕患者按治疗方法分成来曲唑组(34例)和克罗米芬组(33例),先分别给予炔雌醇环丙孕酮片1片/(次·d)和二甲双胍0.5g/次,每日2次,共3～6周期来调整其内分泌相关指标,相关指标恢复正常后来曲唑组于月经周期第3～7天口服来曲唑5 mg/d,连续5d;克罗米芬组于月经周期第3～7天口服克罗米芬50 mg/d,连续5d,通过超声监测、血清学检查观察来曲唑与克罗米芬对卵泡发育、子宫内膜、性激素水平、妊娠结局等方面的影响.观察1～3个月经周期.结果 克罗米芬组患者成熟卵泡数量及平均直径均大于来曲唑组[(2.2±1.5)个比(1.4±1.1)个;(25 ±6)mm比(20±5)mm],子宫内膜厚度及宫腔容积均小于来曲唑组[(7.6±2.0)mm比(9.5 ±1.8) mm;(3.5±1.8)ml比(5.4±1.2)m1],差异均有统计学意义(均P＜0.05).在注射人绒毛膜促性腺激素当日来曲唑组的雌二醇水平明显低于克罗米芬组[(869±131) pmol/L比(1 248±112) pmol/L],黄体生成素峰天数明显高于克罗米芬组[(14.3±1.5)d比(12.5±2.1)d],差异均有统计学意义(均P＜0.05).来曲唑组患者的排卵率、未破裂卵泡黄素化综合征发生率(LUFS)、卵巢过度刺激综合征(OHSS)发生率均明显低于克罗米芬组[64.7％ (44/68)比80.0％(56/70);2.3％(1/44)比14.3％(8/56);0.0％ (0/44)比10.7％ (6/56)],生化妊娠率、临床妊娠率均明显高于克罗米芬组[50.0％(22/44)比32.1％ (17/56);47.7％ (21/44)比28.6％ (16/56)],差异均有统计学意义(均P＜0.05).结论 虽然克罗米芬治疗PCOS致不孕患者的促排卵效果优于来曲唑,但来曲唑的妊娠率较高,多胎妊娠率、LUFS发生率及OHSS发生率较低.
目的 比較來麯唑和剋囉米芬對多囊卵巢綜閤徵(PCOS)緻不孕患者誘髮排卵的臨床效果及妊娠結跼.方法 將67例PCOS緻不孕患者按治療方法分成來麯唑組(34例)和剋囉米芬組(33例),先分彆給予炔雌醇環丙孕酮片1片/(次·d)和二甲雙胍0.5g/次,每日2次,共3～6週期來調整其內分泌相關指標,相關指標恢複正常後來麯唑組于月經週期第3～7天口服來麯唑5 mg/d,連續5d;剋囉米芬組于月經週期第3～7天口服剋囉米芬50 mg/d,連續5d,通過超聲鑑測、血清學檢查觀察來麯唑與剋囉米芬對卵泡髮育、子宮內膜、性激素水平、妊娠結跼等方麵的影響.觀察1～3箇月經週期.結果 剋囉米芬組患者成熟卵泡數量及平均直徑均大于來麯唑組[(2.2±1.5)箇比(1.4±1.1)箇;(25 ±6)mm比(20±5)mm],子宮內膜厚度及宮腔容積均小于來麯唑組[(7.6±2.0)mm比(9.5 ±1.8) mm;(3.5±1.8)ml比(5.4±1.2)m1],差異均有統計學意義(均P＜0.05).在註射人絨毛膜促性腺激素噹日來麯唑組的雌二醇水平明顯低于剋囉米芬組[(869±131) pmol/L比(1 248±112) pmol/L],黃體生成素峰天數明顯高于剋囉米芬組[(14.3±1.5)d比(12.5±2.1)d],差異均有統計學意義(均P＜0.05).來麯唑組患者的排卵率、未破裂卵泡黃素化綜閤徵髮生率(LUFS)、卵巢過度刺激綜閤徵(OHSS)髮生率均明顯低于剋囉米芬組[64.7％ (44/68)比80.0％(56/70);2.3％(1/44)比14.3％(8/56);0.0％ (0/44)比10.7％ (6/56)],生化妊娠率、臨床妊娠率均明顯高于剋囉米芬組[50.0％(22/44)比32.1％ (17/56);47.7％ (21/44)比28.6％ (16/56)],差異均有統計學意義(均P＜0.05).結論 雖然剋囉米芬治療PCOS緻不孕患者的促排卵效果優于來麯唑,但來麯唑的妊娠率較高,多胎妊娠率、LUFS髮生率及OHSS髮生率較低.
목적 비교래곡서화극라미분대다낭란소종합정(PCOS)치불잉환자유발배란적림상효과급임신결국.방법 장67례PCOS치불잉환자안치료방법분성래곡서조(34례)화극라미분조(33례),선분별급여결자순배병잉동편1편/(차·d)화이갑쌍고0.5g/차,매일2차,공3～6주기래조정기내분비상관지표,상관지표회복정상후래곡서조우월경주기제3～7천구복래곡서5 mg/d,련속5d;극라미분조우월경주기제3～7천구복극라미분50 mg/d,련속5d,통과초성감측、혈청학검사관찰래곡서여극라미분대란포발육、자궁내막、성격소수평、임신결국등방면적영향.관찰1～3개월경주기.결과 극라미분조환자성숙란포수량급평균직경균대우래곡서조[(2.2±1.5)개비(1.4±1.1)개;(25 ±6)mm비(20±5)mm],자궁내막후도급궁강용적균소우래곡서조[(7.6±2.0)mm비(9.5 ±1.8) mm;(3.5±1.8)ml비(5.4±1.2)m1],차이균유통계학의의(균P＜0.05).재주사인융모막촉성선격소당일래곡서조적자이순수평명현저우극라미분조[(869±131) pmol/L비(1 248±112) pmol/L],황체생성소봉천수명현고우극라미분조[(14.3±1.5)d비(12.5±2.1)d],차이균유통계학의의(균P＜0.05).래곡서조환자적배란솔、미파렬란포황소화종합정발생솔(LUFS)、란소과도자격종합정(OHSS)발생솔균명현저우극라미분조[64.7％ (44/68)비80.0％(56/70);2.3％(1/44)비14.3％(8/56);0.0％ (0/44)비10.7％ (6/56)],생화임신솔、림상임신솔균명현고우극라미분조[50.0％(22/44)비32.1％ (17/56);47.7％ (21/44)비28.6％ (16/56)],차이균유통계학의의(균P＜0.05).결론 수연극라미분치료PCOS치불잉환자적촉배란효과우우래곡서,단래곡서적임신솔교고,다태임신솔、LUFS발생솔급OHSS발생솔교저.
Objective To compare the effect of induced ovulation and pregnancy results of letrozole(LE) and clomiphene citrate(CC) treating polycystic ovary syndrome (PCOS).Methods Sixty-seven cases of PCOS patients were randomly divided into two groups,with 34 cases in LE group and 33 cases in CC group.The patients were treated with LE 5 mg and CC 50 mg respectively in the menstrual cycle of 3-7d for five days.The effects of LE and CC on follicular development,endometrial,sex hormone level and pregnancy outcome were observed.Results The mature follicle number and average diameter in CC group were higher than those in LE group [(2.2 ±1.5) vs (1.4 ± 1.1) ; (25 ± 6) mm vs (20 ± 5) mm],while the thickness of endometrium and uterine cavity volume in CC group were less than those in LE group [(7.6 ± 2.0) mm vs (9.5 ± 1.8) mm ; (3.5 ± 1.8) ml vs (5.4 ±1.2) ml] ; the differences were statistically significant(P ＜ 0.05).Serum estradiol levels on the day of HCG injection in LE group were less than those in the CC group[(869 ± 131) pmol/L vs (1 248 ± 112)pmol/L],but the LH peak was higher than that in CC group[(14.3 ± 1.5) d vs (12.5 ± 2.1) d] ; the difference was statistically significant (P ＜ 0.05).The ovulation rate,incidence of luteinized unrup tured follicle syndrome (LUFS) and ovarian hyperstimulation syndrome (OHSS) in LE group were lower than those in CC group [64.7％ (44/68) vs 80.0％ (56/70) ; 2.3 ％ (1/44) vs 14.3 ％ (8/56) ;0.0％ (0/44) vs 10.7 ％ (6/56)],but the biochemical pregnancy rate and the clinical pregnancy rate in LE group were significantly higher than those in CC group [50.0％ (22/44) vs 32.1％ (17/56) ;47.7％ (21/44) vs 28.6％ (16/56)] ; the difference had statistical significance (P ＜ 0.05).Conclusion Although the ovulation effect of CC is better than that of LE,the LE has the higher pregnancy rate,lower rate of multiple pregnancy and less incidence of LUFS and OHSS.
