CAJ | 학술논문

目的：系统比较来曲唑3种常用剂量（2．5、5．0、7．5mg）促排卵治疗的疗效。方法计算机检索CNKI、万方数据库、PubMed、Cochrane Library ，收集有关随机对照试验和临床对照试验，由2位研究者独立进行文献筛选、资料提取和方法学质量评价后，采用RevMan 5．0软件进行Meta分析。结果共纳入8个研究，方法学质量评估6个为高质量，2个为低质量。Meta分析结果显示，与来曲唑2．5 mg组比较，来曲唑5．0 mg组 HCG日子宫内膜更薄，可获得更多的成熟卵泡个数，卵泡成熟所需时间较短；来曲唑7．5 mg组卵泡成熟所需时间较短。随着来曲唑剂量的增加，卵泡成熟所需时间缩短。结论来曲唑5．0mg×5d剂量可获得更多的成熟卵泡，缩短卵泡成熟时间，促卵泡成熟所需时间更接近于自然排卵日，子宫内膜厚度更有利于受孕，有利于提高妊娠率，在促排卵成熟方面比较有优势，可作为临床促排卵的推荐剂量。
목적：계통비교래곡서3충상용제량（2．5、5．0、7．5mg）촉배란치료적료효。방법계산궤검색CNKI、만방수거고、PubMed、Cochrane Library ，수집유관수궤대조시험화림상대조시험，유2위연구자독립진행문헌사선、자료제취화방법학질량평개후，채용RevMan 5．0연건진행Meta분석。결과공납입8개연구，방법학질량평고6개위고질량，2개위저질량。Meta분석결과현시，여래곡서2．5 mg조비교，래곡서5．0 mg조 HCG일자궁내막경박，가획득경다적성숙란포개수，란포성숙소수시간교단；래곡서7．5 mg조란포성숙소수시간교단。수착래곡서제량적증가，란포성숙소수시간축단。결론래곡서5．0mg×5d제량가획득경다적성숙란포，축단란포성숙시간，촉란포성숙소수시간경접근우자연배란일，자궁내막후도경유리우수잉，유리우제고임신솔，재촉배란성숙방면비교유우세，가작위림상촉배란적추천제량。
Objective To evaluate the efectiveness of different doses of letrozole on ovulation in infertility patients . Methods The databases such as CNKI ,WanFang Data ,PubMed and The Cochrane Librar were searched to collect randomized controlled trials (RCTs)and controlled clinical trials(CCTs)for the comparison of the effectiveness of different doses of letrozole in ovulation induction . T he quality of the retrieved trials was critically appraised and Meta‐analyses were conducted using RevMan 5 .0 software . Results Eight studies were included and six of them were high quality . The results of Meta‐analyses showed there were no significant differences between letrozole 2 .5 mg and 5 .0 mg in the diameter of ma‐ture follicle ,ovulation rate ,pregnancy rate and miscarriage rate ,but there were significant differences in the endometrial thickness ,follicular mature time and the number of mature follicles ,letrozole 5 .0 mg group led to thinner endometrial thickness ,needed less time to achieve follicular maturity ,produced more mature follicles . The indexes of effectiveness such as endometrial thickness ,the number of mature follicles ,ovu‐lation rate ,pregnancy rate ,miscarriage rate were not statistically significant between lertozole 5 .0 mg group and 7 .5 mg group ,there were significant differences in the follicular mature time ,it needed less time to achieve follicular maturity in letrozole 7 .5 mg group . Conclusions Letrozole at the dose of 5 .0 mg per day led to thinner endometrial thickness ,needed less time to achieve follicular maturity ,produced more ma‐ture follicles and increased the rate of pregnancy . Letrozole at the dose of 5 .0 mg per day can be recom‐mended in clinical .