多囊卵巢综合征导致不孕的危险因素及治疗方案探讨  

Exploring the risk factors causing infertility in women with polycystic ovary syndrome and its treatment programs

作　　者：张建伟 何泓[2] 

机构地区：[1]北京安太嘉园医院妇产科,北京100067 [2]华中科技大学同济医学院附属同济医院妇产科,湖北武汉430030

出　　处：《海南医学》2014年第12期1750-1753,共4页Hainan Medical Journal

基　　金：国家自然科学基金(编号:81000240)

摘　　要：目的探讨多囊卵巢综合征(PCOS)导致不孕的危险因素,并评估不同的药物治疗方案的疗效。方法以152例PCOS患者为病例组,以正常分娩的152例孕产妇为对照组,回顾分析两组的基本特征、相关疾病家族史等指标与PCOS不孕的关联性及关联强度。采用单纯促排卵剂(单纯用药组,76例)和排卵剂联合炔雌醇环丙孕酮、二甲双胍(联合用药组,76例)对152例PCOS患者进行治疗,并评价两组的治疗效果。结果经单因素Logistic回归分析,BMI、肥胖、多毛、痤疮、糖尿病家族史、秃顶家族史、月经紊乱家族史是PCOS导致不孕的危险因素(P<0.05),危险度分别上升1.486倍、4.317倍、28.505倍、12.963倍、3.492倍、4.970倍、15.202倍;多因素Logistic回归分析,肥胖、有糖尿病家族史、有月经紊乱家族史是发生PCOS导致不孕的独立危险因素(P<0.05);经4个月经周期的治疗后,联合用药组的流产率(10.53%)明显低于单纯用药组(25.00%),联合用药组妊娠率(46.05%)明显高于单纯用药组(15.79%,P<0.05)。结论肥胖、有糖尿病家族史、有月经紊乱家族史,是PCOS导致不孕的独立危险因素;治疗时,患者在服用促排卵剂前,最好先服用二甲双胍、炔雌醇环丙孕酮治疗,以提高自然受孕率。Objective To explore the risk factors causing infertility in women with polycystic ovary syn- drome （PCOS） and its treatment programs. Methods A retrospective study was carried out with 152 PCOS patients 1 and 152 normal puerperal women. The risk factors associated with infertility in PCOS were analyzed. The PCOS pa-I tients were divided into twp groups of 76 cases, stimulate ovulation agent only group and combined medication group 1 （a combination of stimulate ovulation agent, ethinyl estradio-cyproterone and metformin）. Results By univariate lo- gistic regression analysis, it was turned out that BMI, obesity, hirsutism, acne, diabetes, family history, family history of baldness, menstrual disorders were risk factors of infertility in PCOS （P〈0.05）. According to multivariate logistic re- gression analysis, obesity, family history of diabetes, family history of menstrual disorders were independent risk fac- tors of infertility in PCOS （P〈0.05）. After treatment for four menstrual cycles, abortion rate of combined medication group （10.53%） was significantly lower than that of stimulate ovulation agent only group （25.00%）, and the pregnancy rate of the combined medication group （46.05%） was significantly higher than that of stimulate ovulation agent only group （15.79%） （P〈0.05）. Conclusions Obesity, family history of diabetes, family history of menstrual disorder were independent risk factors of infertility in PCOS. Besides ovulation agent, it was suggested to take metformin ant ethinyl estradiol-cyproterone as well to improve the natural conception rate.

关 键 词：多囊卵巢综合征(PCOS) 危险因素 治疗方案 

分 类 号：R711.75[医药卫生—妇产科学]