预测多囊卵巢综合征患者对克罗米芬反应性指标的分析  

Evaluation of parameters for predicting the response to clomiphene citrate in women with polycystic ovary syndrome

作　　者：毛会[1] 席稳燕 杨永康[1] 薛翔[1] 符生鱼 

机构地区：[1]西安交通大学第二附属医院,西安710004

出　　处：《中国医师杂志》2015年第12期1823-1826,共4页Journal of Chinese Physician

摘　　要：目的探讨多囊卵巢综合征（PCOS）患者的临床、内分泌及超声检查参数是否与克罗米酚（CC）治疗的反应性相关。方法采用前瞻性研究，85例PCOS不孕患者口服CC50mg／d，共5d。如无反应，在下一周期中CC剂量增加至100mg／d。根据促排卵后是否有优势卵泡发育分为两组：有反应组56例，无反应组29例。比较两组临床、内分泌及B超参数的差异。结果两组月经周期（闭经或月经稀发）租窦卵泡数目（AFC）在反应组与无反应组比较差异有统计学意义（P〈0．05），但两组年龄、血清总睾酮、促卵泡生成素、黄体生成素、体质量指数、胰岛素抵抗指数、血糖以及胰岛素水平比较差异均无统计学意义（P〉0．05）。多元回归分析提示月经周期与AFC可作为预测CC反应性的指标。结论月经周期及AFC可作为简洁而有效的预测PCOS妇女对CC反应性的指标．Objective To investigate whether clinical, endocrine, and sonographic characteristics of infertile women with polycystic ovary syndrome （PCOS） could predict the ovarian response to clomiphene citrate （CC） medication. Methods A prospective study was conducted, 85 women with PCOS were given CC 50 mg per day for 5 days. In the case of an absent response, doses were increased to 100 daily in subsequent cycles. Clinical, endocrine, and sonographic characteristics were compared between responders and nonresponders. Results The cycle history （oligomenorrhea or amenorrhea ） and antra1 follicle count （AFC） were significantly different in responders from those in nonresponders （ P 〈 0. 05 ）. There were no differences in age, serum testosterone, follicle stimulating hormone （ FSH ） , luteotropic hormone （ LH ） , body mass index （BMI）, insulin resistant index （HOMA-IR）, and glucose and insulin levels between the two groups （ P 〉 0.05 ）. In addition, multivariate logistic regression analysis indicated that cycle history and AFC were the predictors of ovarian response to CC treatment. Conclusions The cycle history and AFC can be used as the simple and effective parameters to predict ovarian response to CC treatment in PCOS patients.

关 键 词：多囊卵巢综合征/治疗/超声检查 氯米芬/治疗应用 月经周期 卵泡 

分 类 号：R711.75[医药卫生—妇产科学]