来曲唑、炔雌醇环丙孕酮片联合二甲双胍治疗耐克罗米芬性多囊卵巢综合征60例  

Sixty cases of clomiphene resistant polycystic ovary syndrome treated with letrozole,ethinylestradiol,cycloprotegerin tablet combined with metformin

作　　者：郁从秀 芮茂社 赵馨 YU Congxiu;RUI Maoshe;ZHAO Xin(Department of Pharmacy,Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University,Wuxi,Jiangsu 214000,China;Suzhou BeikangMedical Devices Limited Company,Suzhou,Jiangsu 215028,China)

机构地区：[1]南京医科大学附属无锡妇幼保健院药学部,江苏无锡214000 [2]苏州贝康医疗器械有限公司,江苏苏州215028

出　　处：《安徽医药》2020年第5期999-1002,共4页Anhui Medical and Pharmaceutical Journal

基　　金：南京医科大学科技发展基金项目(2014NJMUZD054)。

摘　　要：目的探讨来曲唑、炔雌醇环丙孕酮片联合二甲双胍治疗耐克罗米芬性多囊卵巢综合征(PCOS)的临床效果。方法选取南京医科大学附属无锡妇幼保健院2017年1月至2018年6月收治的耐克罗米芬PCOS病人120例,采用随机数字表法分为观察组与对照组,对照组(n=60)给予常规炔雌醇环丙孕酮片、二甲双胍治疗,观察组(n=60)在对照组基础上加用来曲唑治疗,观察两组性激素、B超检查等指标改善情况。结果经治疗,观察组病人血清黄体生成素(LH)[(16.37±2.17)mU/L比(24.25±2.47)mU/L]、睾酮(T)[(61.82±5.27)ng/mL比(80.73±5.52)ng/mL]、卵泡刺激素(FSH)[(8.72±2.12)mU/L比(9.84±2.16)mU/L]、催乳素(PRL)[(9.95±1.21)ng/mL比(11.52±1.25)ng/mL]水平均低于对照组,性激素结合球蛋白(SHBG)水平高于对照组[(46.74±3.75)ng/mL比(40.45±3.74)ng/mL],均差异有统计学意义(P<0.05);停药治疗2个月后,观察组病人平均子宫体积大于对照组[(38.75±5.54)cm3比(37.86±5.64)cm3],子宫内膜厚度[(0.51±0.05)mm比(0.59±0.11)mm]、卵巢体积[左侧(5.10±1.05)cm3比(6.56±1.10)cm3][右侧(5.15±1.68)cm3比(6.63±1.06)cm3]、卵泡直径[左侧(0.51±0.05)cm比(0.59±0.05)cm][右侧(0.50±0.03)cm比(0.57±0.06)cm]均小于对照组,卵泡数少于对照组[左侧(15±2)个比(17±1)个][右侧(15±1)个比(17±1)个],均差异有统计学意义(P<0.05);观察组病人治疗后排卵率为91.67%,妊娠成功率为93.33%,均明显高于对照组的75.00%、57.89%,观察组病人早期流产率仅为6.67%,低于对照组的42.11%,组间比较,差异有统计学意义;观察组病人对治疗效果满意度评分为(94.74±3.74)分,明显高于对照组的(78.84±6.73)分,差异有统计学意义(P<0.05)。结论同时使用3种药物(炔雌醇环丙孕酮片、二甲双胍、来曲唑)治疗耐克罗米芬PCOS病人,可使病人临床症状获得显著改善,提高妊娠成功率。Objective To evaluate the clinical effect of letrozole,ethinylestradiol,cycloproterone tablets and metformin in the treat ment of clomiphene resistant polycystic ovary syndrome(PCOS).Methods A total of 120 cases of clomiphene resistant PCOS treated in Wuxi Maternal and Child Health Hospital affiliated to Nanjing Medical Universityfrom January 2017 to June 2018 were selected and divided into the control group and the observation group.The control group(n=60)was treated with routine ethinyl estradioland cyproterone acetate tablets and metformin,while the observation group(n=60)was treated with trazole on the basis of the control group.The improvement of sex hormones and B mode ultrasonography were observed.Results After treatment,the levels of LH[(16.37±2.17)mU/L vs.(24.25±2.47)mU/L],testosterone(T)[(61.82±5.27)ng/mL vs.(80.73±5.52)ng/mL],FSH[(8.72±2.12)mU/L vs.(9.84±2.16)mU/L]and PRL[(9.95±1.21)ng/mL vs.(11.52±1.25)ng/mL]in the observation group were sig nificantly lower than those in the control group,and the SHBG level was significantly higher in the observation group than in the control group[(46.74±3.75)ng/mL vs.(40.45±3.74)ng/mL],there were significant differences between the two groups(P<0.05);After 2 months’withdrawal,the average uterine volume of the observation group was significantly larger than that of the control group[(38.75±5.54)cm3 vs.(37.86±5.64)cm3].The endometrial thickness[(0.51±0.05)mm vs.(0.59±0.11)mm],ovarian volume[left(5.10±1.05)cm3 vs.(6.56±1.10)cm3][right(5.15±1.68)cm3 vs.(6.63±1.06)cm3]and follicle diameter[left(0.51±0.05)cm vs.(0.59±0.05)cm][right(0.50±0.03)cm vs.(0.57±0.06)cm]of the observation group were significantly smaller than those of the control group,and the number of follicles was significantly less than that of the control group[left(15±2)vs.(17±1)][right(15±1)vs.(17±1)],there were significant differences between the two groups(P<0.05);The ovulation rate and pregnancy success rate of the ob servation group after treatment were 91.67%and 93.33%,resp

关 键 词：多囊卵巢综合征 炔诺孕酮合剂炔雌醇 来曲唑 性激素结合球蛋白 子宫内膜 性激素 排卵 妊娠 

分 类 号：R711.75[医药卫生—妇产科学]