摘要
目的观察多囊卵巢综合征患者联合应用二甲双胍与达英-3512周后的不同促排卵方案治疗效果。方法对48例患者测定多囊卵巢综合征基础内分泌、空腹血糖、空腹胰岛素等指标，经联合应用二甲双胍与达英-3512周后复查上述指标，应用不同促排卵方案诱发排卵共76个周期，分为3组：克罗米芬组24个周期；人绝经促性腺激素组20个周期；克罗米芬联合人绝经促性腺激素组32个周期。观察排卵率、妊娠率及卵巢过度刺激综合征等情况。结果48例多囊卵巢综合征患者经联合应用二甲双胍与达英-35后，血黄体生成素、睾酮及黄体生成素／卵泡刺激素较治疗前明显降低（t=7．35，P〈0．01；t=5．43，P〈0．01；t=2．32，P〈0．05），卵巢体积较治疗前明显缩小（t=2．54，P〈0．05）；而卵泡刺激素、胰岛素抵抗及空腹胰岛素、雌二醇有不同程度的上升或下降，但较治疗前无显著性差异。克罗米芬组排卵率为75．0％（18／24），妊娠率为12．5％（3／24），未破卵泡黄素化综合征发生率为8．3％（2／24）；人绝经促性腺激素组排卵率为80．0％（16／20），妊娠率为20．0％（4／20），未破卵泡黄素化综合征发生率为5．0％（1／20），卵巢过度刺激综合征发生率为5．0％（1／20）；克罗米芬联合人绝经促性腺激素组排卵率为81．3％（26／32），妊娠率为28．1％（9／32），未破卵泡黄素化综合征发生率为6．3％（2／32）。结论对多囊卵巢综合征患者行二甲双胍联合达英-35预治疗12周后，再联合应用克罗米芬及人绝经促性腺激素对其诱发排卵是一种安全、有效的治疗方案。
Objective To observe clinical therapeutic effects of different regimens of induced ovulation following 12 weeks of treatment with mefformin combined with Diane-35 （ethinyl estmdiol and cyproterone acetate ） for infertile patients with polycystic ovarian syndrome （PCOS）. Methods The serum levels of endocrine hormones （including FSH, LH, PRL, T, E2 ） , fasting blood glucose （FBG）, fasting insulin（FI） of 48 patients with PCOS at baseline were examined. All patients were treated with combination of mefformin and Diane-35 for 12 weeks. After 12 weeks of treatment, the indexes mentioned above of all subjects were reexamined. Then the patients were induced ovulation by different induced ovulation regimens for 76 cycles ： including clomiphene citrate （CC） for 24 cycles, human menopausal gonadotropin （HMG） for 20 cycles and clomiphene joint HMG （ CC ＋ HMG） for 32 cycles. Ovulation rate, pregnancy rate and incidence rate of ovarian hyperstimulation syndrome（OHSS） in the three groups were observed. Results After 12 weeks of treatment with combination of metformin and Diane-35, the serum levels of LH, T and ratio of LH/FSH of all 48 patients with PCOS were significantly lowered as compared with those before the treatment（ t = 7.35, P 〈 0. 01 ; t = 5.43, P 〈 0.01 ; t = 2.32, P 〈 0. 05 ） and the volume of ovary was decreased significantly （ t = 2.54, P 〈 0.05 ）. While the serum levels of FSH, insulin resistance （ IR ）, FI and E2 were increased or decreased at varied degrees, but there were no significant differences as compared with those before treatment. In CC group, ovulation rate was 75.0% （ 18/24 ）, pregnancy rate was 12.5 % （3/24） and incidence rate of luteinized unruptured follicle syndrome （LUFS） was 8.3 % （2/24）. In HMG group, the ovulation rate was 80.0% （ 16/20）, the pregnancy rate was 20.0% （4/20） and the incidence rate of LUFS was 5.0% （1/20） and the incidence rate of OHSS was 5.0% （1/20）. In CC ＋ HMG group, the ovulation
出处
《中国妇幼健康研究》
2009年第6期677-679,共3页
Chinese Journal of Woman and Child Health Research
