齐齐哈尔医学院学报
齊齊哈爾醫學院學報
제제합이의학원학보
JOURNAL OF QIQIHAR MEDICAL COLLEGE
2015年
9期
1332-1334
,共3页
多囊卵巢综合征%排卵诱导%来曲唑%克罗米芬%来曲唑耐药%克罗米芬耐药%联合用药
多囊卵巢綜閤徵%排卵誘導%來麯唑%剋囉米芬%來麯唑耐藥%剋囉米芬耐藥%聯閤用藥
다낭란소종합정%배란유도%래곡서%극라미분%래곡서내약%극라미분내약%연합용약
Polycystic ovary syndrome%Ovulation induction%Letrozole%J Romy Finn%Letrozole resistance%J Romy Finn resistance%Combined medication
目的：比较来曲唑联合克罗米芬治疗曾经单独接受克罗米芬和曲唑治疗均耐药的多囊卵巢综合征（ PCOS）不孕患者的促排卵治疗效果。方法选择自2013年1月至2014年10月在我院生殖中心促排卵治疗的多囊卵巢综合征患者25例，入组女性要求既往应用克罗米芬至少6个周期促排卵后未能形成优势卵泡，随后又应用来曲唑4个周期仍无法形成优势卵泡的患者入选应用来曲唑和克罗米芬联合治疗。观察患者联合用药和单独用药前后卵泡数、排卵率、妊娠率。结果25例患者完成56个促排卵周期，6例患者第3个周期在月经第16天仍未出现优势卵泡而放弃监测；其中48个周期有排卵，2个周期出现卵泡黄素化未破裂，排卵率为85．71％，妊娠10例，妊娠率20．08％。双胎两例，无多胎及卵巢过度刺激病例发生。结论根据这项研究的结果可以提出对于克罗米芬和来曲唑单独应用耐药的 PCOS 患者，在进行可能会有严重并发症或手术等更激进的治疗前，可以尝试这两种药物组合的治疗方案。
目的：比較來麯唑聯閤剋囉米芬治療曾經單獨接受剋囉米芬和麯唑治療均耐藥的多囊卵巢綜閤徵（ PCOS）不孕患者的促排卵治療效果。方法選擇自2013年1月至2014年10月在我院生殖中心促排卵治療的多囊卵巢綜閤徵患者25例，入組女性要求既往應用剋囉米芬至少6箇週期促排卵後未能形成優勢卵泡，隨後又應用來麯唑4箇週期仍無法形成優勢卵泡的患者入選應用來麯唑和剋囉米芬聯閤治療。觀察患者聯閤用藥和單獨用藥前後卵泡數、排卵率、妊娠率。結果25例患者完成56箇促排卵週期，6例患者第3箇週期在月經第16天仍未齣現優勢卵泡而放棄鑑測；其中48箇週期有排卵，2箇週期齣現卵泡黃素化未破裂，排卵率為85．71％，妊娠10例，妊娠率20．08％。雙胎兩例，無多胎及卵巢過度刺激病例髮生。結論根據這項研究的結果可以提齣對于剋囉米芬和來麯唑單獨應用耐藥的 PCOS 患者，在進行可能會有嚴重併髮癥或手術等更激進的治療前，可以嘗試這兩種藥物組閤的治療方案。
목적：비교래곡서연합극라미분치료증경단독접수극라미분화곡서치료균내약적다낭란소종합정（ PCOS）불잉환자적촉배란치료효과。방법선택자2013년1월지2014년10월재아원생식중심촉배란치료적다낭란소종합정환자25례，입조녀성요구기왕응용극라미분지소6개주기촉배란후미능형성우세란포，수후우응용래곡서4개주기잉무법형성우세란포적환자입선응용래곡서화극라미분연합치료。관찰환자연합용약화단독용약전후란포수、배란솔、임신솔。결과25례환자완성56개촉배란주기，6례환자제3개주기재월경제16천잉미출현우세란포이방기감측；기중48개주기유배란，2개주기출현란포황소화미파렬，배란솔위85．71％，임신10례，임신솔20．08％。쌍태량례，무다태급란소과도자격병례발생。결론근거저항연구적결과가이제출대우극라미분화래곡서단독응용내약적 PCOS 환자，재진행가능회유엄중병발증혹수술등경격진적치료전，가이상시저량충약물조합적치료방안。
Objective This article was to explore the promote ovulation effect of letrozole combined with clomiphene in the treatment of polycystic ovary syndrome ( PCOS) patients who once accepted clomiphene and letrozole treatment separately and resistant to clomiphene and letrozole.Methods From January 2013 to October 2014, 25 patients with polycystic ovary syndrome and received induction of ovulation treatment in the reproductive center in our hospital were enrolled as study.The women include in this study were required to received the treatment of clomiphene previous for ovulation at least six cycles but fail to form a dominant follicle, nor to form a dominant follicle after the application of letrozole for four cycles.They were treated with letrozole combined with clomiphene citrate.The number of follicles, the ovulation rate and pregnancy rate were observed.Results 25 patients completed 56 cycles of ovulation.At the third cycle, 6 patients gave up monitoring after failed to present the dominant follicle at the sixteenth day after menstruation.48 cycles with ovulation, 2 cycles occurred luteinized but without ruptured follicle, ovulation rate was 85.71%, 10 cases of patients got pregnant and the pregnancy rate was 20.08%.There were two cases of twins, no multiple pregnancies and ovarian hyper-stimulation occurred. Conclusions When PCOS patients resistant to clomiphene or letrozole alone, the combination use of them can be considered as a new method before other treatment which could induce serious complications.
