来曲唑与克罗米芬对PCOS患者促排卵Meta分析  

The Meta-Analysis for the Effects of Letrozole and Clomiphene Citrate for Induction Ovulation in Women with Polycystic Ovary Syndrome

作　　者：占伏良[1] 谭布珍[1] 肖仲清[2] 

机构地区：[1]南昌大学第二附属医院妇产科 [2]江西省妇幼保健院肿瘤科,南昌330006

出　　处：《江西医学院学报》2009年第12期65-69,共5页Acta Academiae Medicinae Jiangxi

摘　　要：目的评价来曲唑与克罗米芬对多囊卵巢综合征不孕症患者促排卵的效果。方法全面检索来曲唑与克罗米芬对比试验,提取数据资料,应用系统评价专用处理软件RevMan4.2进行入选研究的同质性检验和数据的合并分析。结果共有9篇文献被纳入本研究,来曲唑与克罗米芬比较,排卵率(RR1.09,95%CI0.89～1.35,P=0.40)、妊娠率(RR1.04,95%CI0.84～1.29,P=0.71)、流产率(RR1.08,95%CI0.45～2.60,P=0.87)均无显著性差异;而来曲唑与克罗米芬比较,优势卵泡数更低(WMD-0.78,95%CI-1.21～-0.35,P=0.0004),HCG日子宫内膜厚度更厚(WMD1.60,95%CI0.06～3.14,P=0.04),HCG日雌二醇水平更低(WMD-343.79,95%CI-470.30～-217.28,P<0.00001),比较均有显著性差异。结论多囊卵巢综合征患者使用来曲唑和克罗米芬诱导排卵效果无显著性差异,尚无充分证据证明来曲唑的疗效优于克罗米芬。Objective To evaluate the effect of letrozole and clomiphene citrate （CC） for induction ovulation in women with polycystic ovary syndrome（PCOS）.Methods Browsing the studies thoroughly,followed by taking up the data for meta-analysis by RevMan 4.2.Results Nine studies were included in the meta-analysis.The results were no significant for ovulatory rate （RR 1.09,95% CI 0.89~1.35,P=0.40） in the letrozole group comparing to CC group,or for pregnancy rate（RR 1.04,95% CI 0.84~1.29,P=0.71）,or for miscarriage rate （RR 1.08,95%CI 0.45~2.60,P=0.87）.It was less the numbers of follicles≥18 mm in diameter （WMD-0.78,95% CI -1.21^-0.35,P=0.0004） in the letrozole group comparing to CC,and there was lower estradiol level on day of HCG administration （WMD-343.79,95% CI-470.30^-217.28,P0.00001）.The endometrial thickness on day of HCG administration was thicker（WMD 1.60,95%CI 0.06~3.14,P=0.04）in the letrozole groups comparing to CC.Conclusion Letrozole is as effective as CC for induction ovulation in patients with PCOS.But there is no evidence to show any advantage to the use of letrozole over clomiphene citrate.

关 键 词：多囊卵巢综合征 来曲唑 克罗米芬 促排卵 

分 类 号：R711.6[医药卫生—妇产科学]