人绒毛膜促性腺激素序贯治疗低促性腺激素性闭经致不孕不育的临床疗效分析  

Sequential therapy with human chorionic gonadotropin for infertility caused by low gonadotropin induced amenorrhea

作　　者：陈丽敏[1] 李小莉 李立兴[1] CHEN Limin;LI Xiaoli;LI Lixing(Department of Gynaecology,Jianyang People's Hospital,Jianyang Sichuan 641400,China)

机构地区：[1]简阳市人民医院妇科,四川简阳641400

出　　处：《空军医学杂志》2019年第2期128-131,共4页Medical Journal of Air Force

基　　金：四川省卫生厅科研课题(100484)

摘　　要：目的探讨人绒毛膜促性腺激素序贯治疗低促性腺激素性闭经致不孕不育的临床疗效。方法选取2012年5月—2016年12月简阳市人民医院收治的82例低促性腺激素性闭经致不孕不育的患者作为研究对象,采用回顾性分析法分析所有患者的临床资料,根据其治疗方法将其分为对照组40例和观察组42例,所有患者均予所患疾病基础对症治疗,对照组患者予以人工月经周期联合尿促性腺激素肌肉注射治疗,观察组患者予在对照组治疗基础上予以人绒毛膜促性腺激素序贯治疗,治疗结束后比较2组患者其相关临床指标水平、临床疗效以及不良反应情况。结果治疗前2组患者血清雌二醇(estradiol,E2)、黄体生成素(luteinizing hormone,LH)、促卵泡素(follicle stimulating hormone,FSH)、催乳素(prolactin,PRL)、孕酮(progesterone,P)水平比较差异均无统计学意义,治疗后观察组E2、LH、FSH、PR L及P水平均较对照组上升明显(P<0.05);治疗前2组子宫状况比较差异无统计学意义,治疗后观察组患者其子宫和卵巢体积均较对照组增大,而子宫内膜厚度较对照组增厚,优势卵泡数目较对照组增多(P<0.05);治疗后观察组妊娠成功率显著高于对照组,而卵泡发育失败和卵泡成熟但未成功妊娠发生率较对照组均明显低(P<0.05);2组患者均未出现明显严重不良反应。结论人绒毛膜促性腺激素可明显提高低促性腺激素闭经所致不孕不育患者其E2、LH、FSH、PR L及P水平和妊娠成功率,且具有一定的安全性,值得作为临床上治疗低促性腺激素闭经所致不孕不育患者的首选药物。Objective To investigate the clinical effects of human chorionic gonadotropin(HCG)sequential therapy for infertility caused by low gonadotropin induced amenorrhea.Methods Eighty-two cases of low gonadotropic amenorrhea induced infertility patients treated in our hospital between May 2012 and December 2016 were selected as subjects,whose clinical data was analyzed retrospectively.According to treatment methods,these patients were divided into control group(40 cases)and observation group(42 cases).All the patients were given basic treatment.The patients in control group were treated with artificial menstrual cycles combined with intramuscular injection of urinary gonadotropin,while those in the observation group were additionally treated with HCG.After treatment,the clinical indexes,clinical efficacy and adverse reactions were compared between the two groups.Results There was no difference in the levels of E2,LH,FSH,PRL or P between the two groups before treatment.After treatment,these levels increased significantly(P<0.05).There was no difference in uterine conditions of patients between the two groups before treatment.After treatment,the volume of the uterus and ovary of patients in observation group increased more significantly than in control group.The endometrium of patients in observation group was thicker than in control group,and the number of dominant follicles increased more significantly in observation group than in control group(P<0.05).The pregnancy rate of patients in observation group was significantly higher than that of control group,while the failure rate of follicular development and follicle maturation and the rate of unsuccessful pregnancy were significantly lower than in control group(P<0.05).There were no serious adverse reactions in either group.Conclusion Human chorionic gonadotropin can obviously increase the levels of E2,LH,FSH,PRL,P and pregnancy rate of infertile patients with low gonadotropin amenorrhea,and it is quite safe.It should be the first choice for clinical treatment of infert

关 键 词：人绒毛膜促性腺激素 序贯治疗 低促性腺激素性闭经 不孕不育 临床价值 

分 类 号：R711.6[医药卫生—妇产科学]