早发型与晚发型卵巢过度刺激综合征的临床、实验室特点  

Clinical,Laboratory Characteristics and Prognosis of Early and Late Ovarian Hyperstimulation Syndrome

作　　者：陈宇锋 徐嘉聆 陈慧慧[1] 吴燕虹[1] 付养华 赵军招[1] Chen Yufeng;Xu Jialing;Chen Huihui(Department of Obstetrics and Gynecology,The Second Affiliated Hospital of Wenzhou Medical University,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第二医院生殖中心,325000

出　　处：《医学研究杂志》2020年第12期94-98,103,共6页Journal of Medical Research

基　　金：浙江省温州市生殖遗传重点创新团队项目(C20170007)。

摘　　要：目的探讨早发型与晚发型卵巢过度刺激综合征(OHSS)的临床和实验室特点。方法对72例OHSS患者进行回顾性分析,根据人绒毛膜促性腺激素(HCG)给药后发生OHSS时间,分为早发组与晚发组。比较两组患者的基本情况、实验室指标、入院前与治疗后临床指标。结果早发组多囊卵巢综合症(PCOS)比例、窦卵泡数(AFC)、HCG日E2值、获卵数均高于晚发组,而HCG用量较低(P<0.05)。与晚发组比较,早发组卵巢面积更大,腹痛多见而胸腔积液少见(P<0.05)。晚发组移植囊胚比早胚更易发生胸腔积液(P=0.049),早发组白蛋白用量低于晚发组(P<0.05)。与入院时比较,出院时早发组患者卵巢面积减小(P<0.05),而晚发组比较差异无统计学意义(P>0.05)。结论对于PCOS、高AFC、HCG日E2值高、获卵数多的患者,更易发生早发型OHSS,取卵后应紧密随访。对于晚发型OHSS需关注胸腔积液的情况,预防症状加重。Objective To study the clinical manifestations and laboratory data of early and late ovarian hyperstimulation syndrome(OHSS).Methods Severty two OHSS women were retrospectively enrolled in this study and were divided into early OHSS group and late OHSS group depending on the time that the syndrome was initiated after human chorionic gonadotropin(HCG)administration.Patient′s characteristics,laboratory indicators,clinical data before and after treatment between the early and late OHSS groups were compared.Results The number of patients with polycystic ovary syndrome(PCOS),antral follicle count(AFC),E2 level of HCG day,and number of oocytes retrieved were higher in the early OHSS group than those in the late OHSS group,while the HCG dosage was lower in the early OHSS group(P<0.05).Compared with the late group,the early OHSS group had larger ovaries,higher rate of women with abdominal pain and less with pleural effusion(P<0.05).Women with blastocyst-stage embryo transfer were more likely to have pleural effusion than women with early-stage embryo transfer in late OHSS group(P=0.049).The usage of albumin in the early OHSS group were significantly lower than those in the late OHSS group(P<0.05).Compared with the day of being hospitalized,the ovaries were significantly smaller when discharged in the early OHSS group(P<0.05),but there was no statistical difference in the late OHSS group(P>0.05).Conclusion For patients with PCOS,higher number of AFC,higher E2level on HCG day or higher number of oocytes retrieved who underwent assisted reproductive technology,we believe that they are more likely to have early OHSS and should be followed up after HCG administration to achieve early detection and early treatment.As for the patients with late OHSS,it is necessary to pay close attention to the condition of pleural effusion and deal with it as soon as possible to prevent getting worse.

关 键 词：卵巢过度刺激综合征 卵泡期超长方案 早发型 晚发型 

分 类 号：R71[医药卫生—妇产科学]