来曲唑序贯氯米芬在多囊卵巢综合征患者中的应用  

The Effectiveness of Letrozole Sequential with Clomiphene Citrate for Ovulation Induction in Women with Polycystic Ovary Syndrome

作　　者：何丽[1] 赵勇[2] 李敏[2] 刘玲玲[2] 王蔼明[1] 

机构地区：[1]南方医科大学第三临床医学院,广东广州510515 [2]海军总医院,北京100048

出　　处：《实用妇产科杂志》2017年第1期27-30,共4页Journal of Practical Obstetrics and Gynecology

基　　金：首都医学发展科研基金(编号:2005-3079)

摘　　要：目的:探讨来曲唑(LE)序贯氯米芬(CC)对多囊卵巢综合征(PCOS)患者的促排卵效果。方法:分析PCOS患者共62例,72个促排周期。按促排卵方案分为LE序贯尿促性素(HMG)组和LE序贯CC组,比较两组单卵泡率、HCG日子宫内膜厚度、未成熟卵泡率、排卵率、卵泡过度刺激综合征(OHSS)发生率、临床妊娠率、多胎妊娠率及用药时间、费用的差异。结果:LE序贯HMG组和LE序贯CC组的单卵泡率分别为78.95%、88.24%,未成熟卵泡率为7.89%、2.94%,排卵率分别为89.47%、97.06%,OHSS发生率分别为5.26%、0,临床妊娠率分别为13.16%、11.76%,多胎妊娠率分别为5.26%、2.94%,差异均无统计学意义(P>0.05),LE序贯HMG组HGC日子宫内膜厚度(10.27±1.92 mm)明显厚于LE序贯CC组(9.13±2.32 mm)(P<0.05)。LE序贯CC组用药时间(10.00±0.00天)明显少于LE序贯HMG组(12.16±1.98天)(P<0.05)。LE序贯HMG组的费用明显高于LE序贯CC组。结论:LE序贯CC与LE序贯HMG的排卵效果及妊娠率近似,OHSS发生率无明显差别,LE序贯CC用药时间更短,费用更低,但HCG日子宫内膜更薄,应用中应适当补充雌激素促进内膜生长。Objective： To evaluate the effectiveness of letrozole（ LE） sequential with clomiphene citrate（ CC） for ovulation induction in women with polycystic ovary syndrome（ PCOS）. Methods： The data of 62 infertile women（ 72 cycles） with PCOS undergone ovulation induction treatment were collected for the observational study.The patients were divided into two groups according to the treatments： LE sequential with HMG group and LE sequential with CC group.The rate of monofollicular development,endometrial thickness at injecting HCG,immature follicles,ovulation,OHSS,clinical pregnancy,multiple pregnancies and duration of medication were compared between the two groups.Results： In LE sequential with HMG group and LE sequential with CC group,the monofollicular development rate was 78. 95%、88. 24%,immature follicles rate was7. 89%、2. 94%,ovulation rate was 89. 47%、97. 06%,OHSS rate was 5. 26%、0,clinical pregnancy rate was 13. 16%、11. 76%,multiple pregnancies was 5. 26%、2. 94%,and no significant difference（ P〉0. 05） was observed.Endometrial thickness in LE sequential with CC group（ 9. 13 ± 2. 32 mm） was significant thicker than LE sequential with HMG group（ 10. 27 ± 1. 92mm）（ P〈0. 05）. The duration of medication in LE sequential with CC group（ 10. 00 ± 0. 00 days） was significant shorter than LE sequential with HMG group（ 12. 16±1. 98 days）（ P〈0. 05）.The cost of LE sequential with HMG group was higher than LE sequential with CC group.Conclusions： LE sequential CC group and LE sequential HMG group can both obtain good effect of ovulation and pregnancy rate.The rate of OHSS has no obvious difference.The intrauterine membrane of HCG days is thinner and the duration of medication is shorter in LE sequential CC group.

关 键 词：来曲唑 氯米芬 多囊卵巢综合征 促排卵 

分 类 号：R711.75[医药卫生—妇产科学]