溴隐亭预防卵巢过度刺激综合征的疗效观察  

The preventive effect of bromocriptine for ovarian hyperstimulation syndrome

作　　者：黄青[1] 吴乙璇[1] 刘海英[1] 张伟良[1] 刘见桥[1] 

机构地区：[1]广州医科大学附属第三医院生殖中心广东省产科重大疾病重点实验室广东省普通高校生殖与遗传重点实验室,广东广州510150

出　　处：《中国妇幼保健》2015年第19期3214-3217,共4页Maternal and Child Health Care of China

基　　金：广东省科技厅项目〔2013B022000022〕;广东省医学科研基金项目〔A2014316〕

摘　　要：目的：探讨溴隐亭在卵巢过度刺激综合征（ ovarian hyperstimulation syndrome, OHSS）高危患者中的预防效果。方法：回顾性分析2013年7月-2014年6月期间在我院生殖中心为实施体外受精～胚胎移植／卵胞浆内单精子显微注射（ in vitrofertilization and embryo transfer/intracytoplasmic sperm injection, IVF-ET/ICSI）治疗而进行控制性超促排卵（controlled ovarian by-perstimulation, COH）的患者资料，选取其中采用常规黄体中期降调节长方案，符合相关标准的312例OHSS高危患者资料为研究对象。患者全部取消新鲜周期移植，改为全胚冷冻择期移植。其中125例患者未采取其他主动预防措施，为对照组；其余187例患者从人绒毛膜促性腺激素（human chorionic gonadotrophin, HCG）注射13开始，口服溴隐亭2．5mg，2次／日，连续14日，为实验组。比较两组患者OHSS的发生情况。结果：两组患者间年龄、体质量指数（BMI）、不孕年限、不孕原因、既往IVF周期数、既往OHSS周期数、基础FSH、基础窦卵泡数、促排卵时间、促性腺激素（Gn）使用量、HCG日E2、HCG日直径≥14mm的卵泡数、获卵数等指标比较，差异无统计学意义（P〉0．05）。对照组发生12例中度OHSS，2例重度OHSS，实验组只有7例中度OHSS，未见重度OHSS，两组患者间中／重度OHSS发生率的比较，差异具有统计学意义（11．2％YS3．7％，，=6．636，P=0．019）。两组患者轻度OHSS发生率相当（对照组60．0％VS实验组60．4％，，=0．006，P=1．000）。结论：在全胚冷冻择期移植的基础上，配合口服溴隐亭，可改善OHSS高危患者的结局，降低中重度OHSS发生率。Objective： To evaluate the preventive effect of bromocriptine for ovarian hyperstimulation syndrome （OHSS）. Meth- ods： It was a comparative, retrospective study wherein 312 OHSS high risk patients undergoing controlled ovarian hyperstimulation （COH） for IVF/ICSI after meeting the strict inclusion and the exclusion criteria during July 2013 and June 2014, were divided into control group （n = 125 ） and study group accroding to their OHSS managing strategies. Patients in control group accepted frozen-thawed embryo transfer af- ter all embryo freezing, and without any active prevention while patients in study group accepted frozen-thawed embryo transfer after all em- bryo freezing, combined with oral bromocriptine （2. 5rag, bid, started from the HCG day and continued for 14d） . The OHSS demogra- phics between the two groups were compared. Results： There were no statistical differences in terms of age, body mass index, duration of infertility, demography of infertility factors, past cycle number, past OHSS cycle, basal hormone level （ FSH [ mIU/ml ] ）, basal antral follicle count, length of ovarian stimulation （days） , total dose of gonadotropin, number of follicle ≥14mm on the day of hCG trigger and the number of oocytes retrieved between the two groups. The study group ended a much lower incidence rate of moderate/severe OHSS （3.7% vs ll. 2% , Xz =6. 636, P=0. 019） but there was no statistical difference between the two group in incidence rate of mild OHSS （60. 0% for control group vs 60.4% for study group, X^2 =0. 006, P= 1. 000） . Conclusion： Oral bromocriptine, combined with frozen- thawed embryo transfer after all embryo freezing, could reduce the incidence rate of moderate/severe OHSS.

关 键 词：溴隐亭 卵巢过度刺激综合征控制性超促排卵 多巴胺受体激动剂 

分 类 号：R321.5[医药卫生—人体解剖和组织胚胎学]