高泌乳素血症对多囊卵巢综合征患者腹腔镜手术治疗效果的影响  

The Effect of Hyperprolactinemia on Polycystic Ovary Syndrome Patients after Laparoscopic Surgery

作　　者：刘玫鸰[1] 李广华[1] 彭雪[1] 杨琳[1] 熊继华[1] 刘雄飞[1] 

机构地区：[1]南昌市第二医院妇产科,南昌330003

出　　处：《实用临床医学（江西）》2009年第3期69-71,74,共4页Practical Clinical Medicine

摘　　要：目的探讨高泌乳素血症对多囊卵巢综合征（PCOS）患者腹腔镜卵巢打孔术（LOD）治疗后效果的影响。方法46例PCOS（治疗组）患者行LOD手术；生育期不明原因的不孕症（对照组）患者46例，其中子宫内膜异位症21例、输卵管粘连17例、盆腔粘连6例、输卵管积水伞端闭锁2例，均行腹腔镜手术治疗。2组分别于术前，术后24h，1、6～10周抽血测定血清卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（T）、硫酸脱氢表雄酮（DHEAS）、泌乳素（PRL）水平，并观察2组手术后10周优势卵泡〉15mm、黄体水平〉5μg／L、自发性月经来潮率及PRL发生率的情况。结果治疗组术后1、6～10周LH水平与术前比较差异有统计学意义（P〈0．01），而术后6～10周T水平、术后24h，1、6～10周PRL水平与术前比较差异均有统计学意义（P〈0．05或P〈0．01）。治疗组术后24h，1、6～10周LH、T、PRL水平与对照组比较差异均有统计学意义（P〈0．05或P〈0．01）。治疗组术后自发性月经来潮率、黄体水平〉5μg／L及高PRL发生率与对照组比较差异均有统计学意义（均P〈0．01）。结论高泌乳素血症的出现会对卵泡发育、排卵产生显著影响，LOD术前、术后测定性激素，特别是PRL是必要的。Objective To explore the effect of hyperprolactinemia on patients with polycystic ovary syndrome （PCOS） after laparoscopic ovarian drilling （LOD） surgery. Methods A total of 92 patients participated in this investigation,including 46 cases of PCOS and 46 cases of autopathic child-bearing period infertility （ACBPI） which involved 21 cases of endometriosis, 17 cases of tubal adhesions,6 cases of pelvic adhesions,and 2 cases of hydrosalpinx closed-end umbrella. The PCOS patients underwent LOD, which served as the treatment group, while the ACBPI patients had laparoscopic exploratory operation,which served as control group. Serum follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone （T）, dehydroepiand-rosterone sulfate （DHEAS） ,and Prolactin （PRL） were determined 24 hours, 1st week, and every week from the 6th to 10th week before and after operation in two groups. Advantage follicles 〉15 mm, the level of yellow body,5 μg/L, spontaneous menstrual rate and PRL generation rate were observed 10- weeks after operation. Results In treatment group,LH levels of 1st week and the 6th to 10th week after operation were statistically significantly different from those of ante-operation （P〈 0.01） ;T levels of the 6th to 10th week after operation,and PRL levels of 24 h,the 1st,and the 6th to 10th-week after operation were statistically significant compared with those of the pre-op-eration （P〈0.05 or P〈0.01）. The LH,T,PRL levels of 24 h,the 1st,and the 6th to 10th week after operation in treatment group had significant difference from those of the control group （P〈 0.05 or P〈0.01）. The rate of spontaneous menstrual,the level of yellow body）5 μg/L,the high generation rate of PRL in treatment group after surgery were markedly different compared with the control group （P〈0.01, respectively）. Conclusion Hyperprolactinemia can exert a notable influence on follicular development and ovulation and it is necessary that sex hormones, especially RPL be dete

关 键 词：多囊卵巢综合征 高泌乳素血症 腹腔镜卵巢打孔术 不孕症 

分 类 号：R711.75[医药卫生—妇产科学]