来曲唑联合GnRH-a治疗用于PCOS患者的研究  

Letrozole Combined with Gonadotropin Releaseing Hormone Agonist Used in Intrauterine Insemination in Patients with PCOS

作　　者：陈益鲁[1] 黄朝霞[1] 侯晓红[1] 

机构地区：[1]温州医学院附属第二医院生殖中心,325000

出　　处：《医学研究杂志》2011年第9期79-81,共3页Journal of Medical Research

基　　金：浙江省人口和计划生育项目(2008-87)

摘　　要：目的探讨来曲唑(LE)以及促性腺激素释放激素激动剂(GnRH-a)用于多囊卵巢综合征(PCOS)患者的治疗效果。方法 50例不孕症常规检查确诊为PCOS并接受促排卵及宫腔内人工授精(IUI)的不孕患者,随机分为来曲唑组(24例):口服LE;HMG组(26例):注射HMG。两组分别于月经周期第3～7天每天口服来曲唑5.0mg或HMG75IU肌内注射,分别监测月经周期第10天子宫内膜厚度,直径≥10mm卵泡个数,记录GnRH-a注射日子宫内膜的厚度、形态,直径≥16mm卵泡(成熟卵泡)个数,直径≥14卵泡(优势卵泡)个数,血清黄体生成素(LH)、雌激素(E2)、睾酮(T)水平,分别统计排卵率及妊娠率,多胎率,卵巢过度刺激综合征(OHSS)发生率。结果与HMG组相比,来曲唑组月经周期第10天子宫内膜厚度薄(P=0.00);GnRH-a注射日血清中E2水平低(P=0.00),T水平高(P=0.004),优势卵泡数少(P=0.02),OHSS发生率低(P=0.04),但临床妊娠率无明显差异(P=0.78)且多胎率低(P=0.02)。结论对PCOS患者,用LE或HMG促排卵,临床妊娠率无差异,用LE联合GnRH-a治疗可以降低HCG日血清中雌激素水平,减少OHSS的发生率,以及多胎率,可望成为一线促排卵药。Objective To explore the effect of letrozole（LE） and GnRH - a on ovulation induction in the patients with polycystic ovay syndrome （PCOS）. Methods 50 patients were divided into two groups, group LE （24 cases）took LE and Group H MG （26 cases）took HMG. The endometrial thickness,average dominant follicle numbers and levels of the EE,T,LH were evaluated on HCG day and the preg- nancy rates,OHSS rates as well. Results Patients took HMG had more average dominant follicle numbers and endometrial thickness after five days treatment than that of took LE （P 〈 0.05 ） ,and also had the higher level of the E2 on hCG day and the OHSS rates（ P 〈 0.05 ）. No significant difference was found in the number of mature follicles and endometrial thickness on HCG day,and clinical pregnancy rate （P 〉 0.05）. Conclusion Letrozole is expected as a first - line drug to induce ovulation.

关 键 词：来曲唑 促性腺激素释放激素 促排卵 宫腔内人工授精 

分 类 号：R339.2[医药卫生—人体生理学]