多囊卵巢综合征合并子宫内膜不典型增生不同治疗方式的疗效及妊娠结局  

Treatment effect and pregnancy outcome of polycystic ovary syndrome complicated with atypical endometrial hyperplasia by different treatment methods

作　　者：杨坤 马晓欣[1] YANG Kun;MA Xiao-xin(Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国实用妇科与产科杂志》2022年第2期223-226,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(81872123);中国医科大学2018年学科建设“重大专项建设计划”(3110118029);盛京自由研究者基金(201601)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)合并子宫内膜不典型增生(AEH)保守治疗的疗效及妊娠情况。方法回顾性收集2016年1月至2019年6月就诊于中国医科大学附属盛京医院要求药物治疗的PCOS合并AEH患者,分为高效孕激素组55例患者、促性腺激素释放激素激动剂(GnRH-a)+左炔诺孕酮宫内缓释系统(LNG-IUS)组14例患者及GnRH-a组13例患者。比较3种方案治疗效果、复发及妊娠情况。结果3种治疗方式的治疗效果及复发率差异无统计学意义,高效孕激素组较GnRH-a组复发时间间隔更长[(14.09±10.99)个月vs.(4.50±1.73)个月,P=0.02],3个月子宫内膜厚度高效孕激素较GnRH-a组厚[(1.04±0.45)cm vs.(0.65±0.40)cm,P=0.02],3组患者辅助受孕妊娠率明显高于自然妊娠[54.17%(13/24)vs.7.69%(1/13),P=0.01],辅助受孕活产率高于自然妊娠[37.50%(9/24)vs.7.69%(1/13),P=0.06]。结论3种治疗方案效果无明显差异,迫切期望妊娠者单用GnRH-a非最佳选择,治愈后有生育要求者,可选择辅助生殖技术受孕。Objective To investigate the curative effect and pregnancy status of polycystic ovary syndrome(PCOS)complicated with endometrial atypical hyperplasia(AEH)in conservative treatment.Methods Patients with PCOS complicated with AEH who requested drug treatment in Shengjing Hospital of China Medical University from January2016 to June 2019 were retrospectively collected.There were 55 patients in the high-efficiency progesterone group,14 patients in the gonadotropin-releasing hormone agonist(GnRH-a)+levonorgestrel intrauterine release system(LNGIUS)group and 13 patients in the GnRH-a group.The therapeutic effect,recurrence and pregnancy status of the three schemes were compared.Results There was no significant difference in the therapeutic effect and recurrence rate among the three treatments.Compared with the GnRH-a group,the recurrence interval was longer in the high progesterone group[(14.09±10.99)months vs.(4.50±1.73)months,P=0.02],and the endometrial thickness at 3 months was thicker in the high progesterone group than in the GnRH-a group[(1.04±0.45)cm vs.(0.65±0.40)cm,P=0.02];The pregnancy rate of assisted pregnancy was significantly higher than that of natural pregnancy[54.17%(13/24)vs.7.69%(1/13),P=0.01],and the live birth rate of assisted pregnancy was higher than that of natural pregnancy[37.50%(9/24)vs.7.69%(1/13),P=0.06].Conclusions There is no significant difference in the effect of the three treatments.Gnrh-a alone is not the best choice for those who are eager to get pregnant.Those who want to have children after cure can choose assisted reproductive technology to get pregnant.

关 键 词：多囊卵巢综合征 子宫内膜不典型增生 治疗 妊娠 

分 类 号：R711.74[医药卫生—妇产科学]