不同剂量来曲唑预防早发型卵巢过度刺激综合征的临床研究  

Effects of letrozole with different doses on preventing the incidence of early-onset ovarian hyperstimulation syndrome

作　　者：张宇晖[1] 何巧花[1] 李杭生[1] 

机构地区：[1]河南省人民医院郑州大学人民医院,郑州450003

出　　处：《生殖与避孕》2016年第9期763-768,共6页Reproduction and Contraception

基　　金：河南省科技厅重点科技攻关项目(132106000081)

摘　　要：目的:探讨卵巢过度刺激综合征(OHSS)高危患者在取卵后应用不同剂量来曲唑(LE)预防早发型OHSS发生的效果。方法:88例患者随机分为4组,A^C组为LE组,取卵即日起每日添加LE,LE剂量分别为A组(n=21)2.5 mg/d,B组(n=23)5.0 mg/d,C组(n=20)7.5 mg/d,D组为对照组(n=24)。测患者黄体期内分泌、血管内皮细胞生长因子(VEGF)水平及中重度OHSS发生率。结果:h CG注射后第5日始血清E_2水平随时间变化呈降低趋势,随着LE剂量增加,E_2水平降低速度明显加快,组间差异有统计学意义(P<0.05)。血清LH水平在注射h CG后第8日、第10日随着LE剂量的增加而逐渐上升,P水平却逐渐降低,组间差异显著(P<0.05)。血清VEGF水平从h CG注射后5日始,D组呈上升趋势,而其它三组呈下降趋势,随着LE剂量的增加,血中VEGF水平越低,各组之间两两比较,差异均具有统计学意义(P<0.001)。C组中重度OHSS发生率低于D组。结论:不同剂量的LE均能一定程度降低血清E_2及VEGF水平,当剂量增至7.5 mg/d时,OHSS发生率最低。Objective： To explore the effects of letrozole with different doses on the incidence of ovarian hyperstimulation syndrome （OHSS） after oocyte retrieval for patients with high-risk OHSS. Methods： According to the different doses of letrozole, 88 patients were randomly divided into group A （2.5 mg, 21 patients）, group B （5.0 mg, 23 patients）, group C （7.5 mg, 20 patients） and group D （control group, 24 patients）. The levels of E2, luteinizing hormone （LH）, progesterone （P） and vascular endothelial growth factor （VEGF） on human chorionic gonadotrophin （hCG） injection day were determined in the four groups after 5 d, 8 d and 10 d ofhCG injection day respectively. The incidence of moderate and severe OHSS was observed in the four groups. Results： From the fifth day after hCG injection, with time extension and the increase in letrozole dose, Ez level was significantly decreased （P〈0.05）. With time extension, LH level was increased and P level was decreased on the eighth and tenth day after hCG injection. From the fifth day after hCG injection, VEGF level was increased in group D, but it was decreased in other groups in a dose-dependent matter with statistical significances among four groups on 5 d, 8 d and 10 d after hCG injection （P〈0.001）. The incidence of moderate and severe OHSS was lower in group C than in group D （P〈0.05）. Conclusion： Letrozole with different doses can decrease the levels of E2 and VEGF. OHSS incidence in 7.5 mg/d was the lowest among different dose groups.

关 键 词：卵巢过度刺激综合征(OHSS) 体外受精(IVF) 来曲唑(LE) 黄体期 

分 类 号：R711.75[医药卫生—妇产科学]