来曲唑治疗不同体质量指数多囊卵巢综合征患者的临床效果  

Clinical effects of body mass index on ovulation induction treatment with letrozole among women with polycystic ovary syndrome

作　　者：张素萍[1,2] 王泽[1] 周亚丽 李敬[1] 路西兰[4] 柏宏伟[4] 石玉华[1] 

机构地区：[1]山东大学附属生殖医院生殖科,山东济南250001 [2]邹城市人民医院妇科,山东邹城273500 [3]曹县县立医院妇产科,山东曹县274400 [4]济南市中心医院生殖医学科,山东济南250013

出　　处：《山东大学学报（医学版）》2017年第5期81-85,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然基金面上项目(81471428;81200423);山东省医药卫生科技发展计划项目(2014WS0122);山东省科技发展计划项目(2014GSF118148)

摘　　要：目的比较不同体质量指数(BMI)的多囊卵巢综合征(PCOS)患者使用来曲唑促排卵的临床效果。方法将2014年1月至2015年12月于山东大学附属生殖医院就诊的153例有生育要求的PCOS患者作为研究对象,根据BMI将患者分为肥胖型组71例和非肥胖型组82例。在患者月经第2~4天开始给予来曲唑5 mg,次/d×5 d促排卵监测并指导同房;比较两组间的促排卵效果。结果肥胖型组的血糖、胰岛素、甘油三酯、高密度脂蛋白及总胆固醇水平高于非肥胖型组(P=0.020,<0.001,0.002,<0.001,0.028),而给予绒促性素(HCG)日雌二醇水平低于非肥胖型组,差异均有统计学意义(P=0.026)。两组患者的优势卵泡数、排卵率、HCG日子宫内膜厚度和促黄体生成素、孕酮等激素水平、妊娠率、流产率及活产率等的比较差异均无统计学意义(P>0.05)。结论不同BMI的PCOS患者可选用来曲唑促排卵,其可提高周期排卵率及妊娠率,肥胖型PCOS患者临床效果与非肥胖型患者相似。Objective To compare the clinical effects of body mass index （BMI） on ovulation induction treatment with letrozole among women with polycystic ovary syndrome （PCOS）. Methods A total of 153 infertile PCOS women treated during Jan. 2014 and Dec. 2015 were enrolled. These women were divided into obese group （n = 71 ） and non- obese group （n =82） according to their BMI. The stimulation was initiated by letrozole at a dose of 5mg daily for 5 days, beginning from day 2 to day 4 of the menstrual cycle. The ovulation induction outcomes of the two groups were compared. Results The obese group had significantly higher serum glucose, insulin, triglyceride, high density lipo- protein （HDL）, and total cholesterol level than the non-obese group （P = 0.020, 〈 0. 001, = 0. 002, 〈 0. 001, = 0.028）. On the day when human chorionic gonadotropin （HCG） was administered, estradiol （E2 ） was statistically lower in the obese group than in the non-obese group （ P = 0.026）. There were no differences in the number of domi- nant follicles, ovulation rate, luteinizing hormone （LH） level on the HCG day, progesterone level, pregnancy rate, miscarriage rate and live birth rate between the two groups （P 〉 0.05）. Conclusion Letrozole is an effective ovulation induction agent for infertile PCOS women with different MBI by improving the ovulation and pregnancy rate.

关 键 词：多囊卵巢综合征 来曲唑 体质量指数 肥胖 活产率 

分 类 号：R588[医药卫生—内分泌]