两种宫腔灌注治疗对薄型子宫内膜患者的疗效对比观察  

Comparison of therapeutic effect of two intrauterine perfusion treatments on patients with thin endometrium

作　　者：龙惠东 王凤[3] 吴迪 邓伟芬 黄玉群 李宇彬 LONG Hui-dong;WANG Feng;WU Di;DENG Wei-fen;HUANG Yu-qun;LI Yu-bin(Dongguan Guangji Hospital,Dongguan 523000;The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000;Shenzhen Hengsheng Hospital,Shenzhen 518000)

机构地区：[1]东莞广济医院生殖中心,东莞523000 [2]中山大学附属第一医院,广州510000 [3]深圳恒生医院,深圳518000

出　　处：《生殖医学杂志》2020年第11期1421-1426,共6页Journal of Reproductive Medicine

基　　金：国家自然科学基金青年项目(81100470);广东省自然科学基金项目(2014A030313182);东莞市社会科技发展一般项目(201950715062735)。

摘　　要：目的探讨富血小板血浆(PRP)与粒细胞集落刺激因子(G-CSF)两种宫腔灌注方法对行体外受精-胚胎移植(IVF-ET)助孕的薄型子宫内膜患者治疗效果。方法2018年7月至2020年3月在本院生殖中心行IVF-ET助孕冻融胚胎移植的薄型子宫内膜患者随机分为3组,分别行PRP宫腔灌注治疗(PRP组,80例)、G-CSF宫腔灌注治疗(G-CSF组,81例)及生理盐水宫腔灌注(对照组,68例)。检测PRP组患者全血及PRP中的血小板浓度以检验PRP制备的有效性;比较3组患者一般情况、内膜厚度及血流分级以及胚胎种植率、临床妊娠率、早期流产率等IVF助孕结局。结果(1)3组患者的一般情况比较差异均无统计学意义(P>0.05);PRP组PRP中的血小板浓度显著高于全血[(433.83±36.76)×109/L vs.(137.17±24.94)×109/L](P<0.001)。(2)3组患者既往周期的移植日内膜厚度比较无显著性差异(P>0.05);PRP组及G-CSF组灌注治疗后的移植日内膜厚度分别为(7.84±0.88)mm和(7.60±0.86)mm,均显著高于治疗前(P<0.001),而两组间比较无显著性差异(P>0.05),但均显著高于对照组(6.98±0.65)(P<0.001);PRP组及G-CSF组治疗后B及C级内膜血流患者比例显著高于对照组(P<0.05)。(3)3组间移植胚胎数、胚胎种植率、临床妊娠率、早期流产率比较均无显著性差异(P>0.05)。结论PRP及G-CSF宫腔灌注均可以促进薄型子宫内膜的增长并改善内膜血流,两种方法比较效果相似,但是对临床妊娠率改善不明显。Objective:To compare the therapeutic effects of intrauterine perfusion treatments with platelet rich plasma(PRP)or granulocyte colony stimulating factor(G-CSF)on thin endometrium patients undergoing IVF-ET.Methods:The thin endometrium patients undergoing frozen embryo transfer in our reproductive center from July 2018 to March 2020 were randomly divided into three groups:PRP intrauterine perfusion(PRP group,n=80),G-CSF intrauterine perfusion(G-CSF group,n=81)and normal saline intrauterine perfusion(control group,n=68).The platelet concentration in whole blood of PRP group was measured to test the effectiveness of PRP preparation.The general condition,endometrium thickness and blood flow classification,embryo implantation rate,clinical pregnancy rate and early miscarriage rate were compared among the three groups.Results:There was no significant difference in basic general conditions among the three groups(P>0.05).The platelet concentration in PRP was significantly higher than that in whole blood in PRP group[(433.83±36.76)×109/L vs.(137.17±24.94)×109/L](P<0.001).There was no significant difference in endometrial thickness in the previous cycle among the three groups(P>0.05).The thickness of endometrium on embryo transfer day after intrauterine perfusion in PRP group and G-CSF group was(7.84±0.88)mm and(7.60±0.86)mm,respectively,which were significantly higher than that before treatment(P<0.001).There was no significant difference between the two groups(P>0.05),but those were all significantly higher than the control group(6.98±0.65)(P<0.001).The proportion of patients with grade B and C blood flow after therapy in PRP group and G-CSF group was significantly higher than that in the control group(P<0.05).There was no significant difference in the number of embryo transferred,embryo implantation rate,clinical pregnancy rate and early miscarriage rate among the three groups(P>0.05).Conclusions:PRP and G-CSF intrauterine perfusion can significantly promote the growth of thin endometrium and improve endometrium

关 键 词：薄型子宫内膜 宫腔灌注 富血小板血浆 粒细胞集落刺激因子 

分 类 号：R711.6[医药卫生—妇产科学]