摘要
目的探讨来曲唑对多囊卵巢综合征(PCOS)患者血流搏动指数(PI)、血流阻力指数(RI)及血清雌二醇(E2)、催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)水平的影响。方法回顾性分析2019年1月至2020年6月就诊于无锡市锡山人民医院鹅湖分院的78例PCOS患者的临床资料,按不同的治疗方案分为氯米芬组(给予100 mg/d氯米芬治疗)、来曲唑A组(在氯米芬组的基础上给予2.5 mg/d来曲唑治疗)及来曲唑B组(在氯米芬组的基础上给予5.0 mg/d来曲唑治疗),各26例。比较3组患者治疗前后子宫内膜容受性、性激素水平,治疗后的排卵、妊娠情况,治疗期间不良反应发生情况。结果与治疗前比,治疗后3组患者子宫内膜厚度、血清FSH水平均显著升高,RI、PI及血清E2、PRL、LH水平均显著降低;与氯米芬组比,治疗后来曲唑A组、来曲唑B组患者子宫内膜厚度、排卵率、血清FSH水平均显著升高,且来曲唑B组显著高于来曲唑A组;而治疗后来曲唑A组、来曲唑B组患者RI、PI及血清E_(2)、PRL、LH水平均显著降低,且来曲唑B组显著低于来曲唑A组;来曲唑B组患者的优良妊娠总发生率均显著高于氯米芬组、来曲唑A组(均P<0.05);3组患者不良反应总发生率比较,差异均无统计学意义(均P>0.05)。结论相比于氯米芬单一治疗,联合来曲唑治疗PCOS,可有效调节其性激素水平,改善患者子宫内膜容受性,从而提高排卵率和优良妊娠率,安全性良好,且治疗剂量为5.0 mg的来曲唑治疗效果更为理想。
Objective To investigate the effects of letrozole on blood pulsatility index(PI),blood resistance index(RI),serum estradiol(E2),prolactin(PRL)and luteinizing hormone(LH),follicle stimulating hormone(FSH)levels in patients with polycystic ovary syndrome(PCOS).Methods The clinical data of 78 cases patients with PCOS treated in Ehu Branch of Wuxi Xishan People's Hospital from January 2019 to June 2020 were retrospectively analyzed.They were divided into the clomiphene group(treated with clomiphene 100 mg/d),the letrozole group A(treated with 2.5 mg/d letrozole on the basis of clomiphene group)and the letrozole group B(treated with 5.0 mg/d letrozole on the basis of clomiphene group)according to different treatment schemes,26 cases in each group.The endometrial receptivity and sex hormone levels before and after treatment,ovulation and pregnancy after treatment,and the occurrence of adverse reactions during treatment of patients were compared among the three groups.Results Compared with before treatment,the endometrial thickness and serum FSH levels of patients in the three groups after treatment increased significantly,while the levels of RI,PI,and serum E_(2),PRL,LH after treatment decreased significantly;compared with the clomiphene group,the endometrial thickness,ovulation rate and serum FSH level of the patients in the letrozole A group and the letrozole B group after treatment increased significantly,and the letrozole B group was significantly higher than the letrozole A group;the RI,PI and serum E2,PRL and LH levels of the patients in the letrozole A group and the letrozole B group after treatment decreased significantly,and the letrozole B group was significantly lower than the letrozole A group;the total incidence of excellent pregnancy in the letrozole B group was significantly higher than that in the clomiphene group and the letrozole A group(all P<0.05);there was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Compared with clomiphene monothe
作者
徐淑静
王小燕
XU Shujing;WANG Xiaoyan(Department of Obstetrics and Gynecology,Ehu Branch of Wuxi Xishan People's Hospital;Department of Clinical Laboratory,Ehu Branch of Wuxi Xishan People's Hospital,Wuxi,Jiangsu 214116,China)
关键词
多囊卵巢综合征
来曲唑
氯米芬
子宫内膜厚度
血流搏动指数
血流阻力指数
Polycystic ovary syndrome
Letrozole
Clomiphene
Endometrial thickness
Blood flow pulsatility index
Blood flow resistance index
