HMG联合来曲唑对多囊卵巢综合征患者性激素基础AMH水平及子宫内膜容受性的影响  

Effects of HMG combined with letrozole on sex hormone,basal AMH levels and endometrial receptivity in patients with polycystic ovary syndrome

作　　者：李枫 武红 姜秋慧 张金磊 Li Feng;Wu Hong;Jiang Qiuhui;Zhang Jinlei(People’s Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学人民医院(郑州人民医院),河南郑州450000

出　　处：《临床心身疾病杂志》2022年第4期38-42,共5页Journal of Clinical Psychosomatic Diseases

基　　金：郑州市科研攻关项目(编号2018001578)。

摘　　要：目的探讨人绝经期尿促性腺激素联合来曲唑治疗多囊卵巢综合征的临床疗效及对患者性激素水平、基础抗苗勒管激素水平、子宫内膜容受性的影响。方法将80例多囊卵巢综合征患者按随机数字表法分为两组,每组40例。两组均予以常规治疗,对照组在此基础上予以人绝经期尿促性腺激素治疗,观察组在对照组基础上联合来曲唑治疗,观察3个周期,随访3个月。比较两组促排卵效果(排卵率、优质卵泡数),比较治疗前及治疗3个周期两组血清性激素指标水平(卵泡刺激素、雌二醇、黄体生成素、睾酮)、基础抗苗勒管激素水平及子宫内膜容受性(子宫内膜厚度、子宫内膜动脉搏动指数、阻力指数)、卵巢间质血流动力学(收缩期最大血流速度、卵巢间质动脉搏动指数、卵巢间质动脉阻力指数)、随访3个月妊娠情况(妊娠率、早期流产率、双胎率)。统计并比较两组不良反应发生率。结果(1)观察组排卵率显著高于对照组(P<0.05),两组优质卵泡数比较差异无统计学意义(P>0.05)。(2)治疗3个周期两组卵泡刺激素、睾酮水平显著高于治疗前(P<0.05),雌二醇、黄体生成素及基础抗苗勒管激素水平显著低于治疗前(P<0.05),两组上述指标比较差异有统计学意义(P<0.05)。(3)治疗3个周期两组子宫内膜厚度显著大于治疗前(P<0.05),子宫内膜动脉搏动指数、阻力指数显著低于治疗前(P<0.05),两组比较差异无统计学意义(P>0.05)。(4)两组卵巢间质动脉收缩期最大血流速度显著小于治疗前(P<0.05),卵巢间质动脉搏动指数、阻力指数显著高于治疗前(P<0.05),两组比较差异均无统计学意义(P>0.05)。(5)治疗3个周期观察组妊娠率显著高于对照组(P<0.05),两组妊娠患者早期流产率、双胎率比较差异无统计学意义(P>0.05)。(6)两组不良反应发生率比较差异无统计学意义(P>0.05)。结论人绝经期尿促性腺激素联合来曲唑治�Objective To investigate the clinical efficacy of human menopausal gonadotropin(HMG)combined with letrozole in the treatment of polycystic ovarian syndrome(PCOS)and its effect on sex hormone,basal anti-Mullerian hormone(AMH)levels and endometrial receptivity.Methods A total of 80 patients with PCOS were divided into two groups according to random number table method,with 40 cases in each group.Both groups were given routine treatment,the control group was given HMG treatment on the basis of this,and the observation group was given letrozole treatment on the basis of the control group.The patients were observed for 3 cycles and followed up for 3 months.The effects of ovulation induction(ovulation rate and number of high-quality follicles)were compared between the two groups.The levels of serum sex hormones indexes[follicle-stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),testosterone(TTE)],basal AMH level and uterine receptivity[endometrial thickness(Em),endometrial artery pulsatility index(PI),resistance index(RI)]were evaluated before treatment and after 3 cycles of treatment.The pregnancy status of the two groups(pregnancy rate,early abortion rate,twins rate)was followed up for 3 months.The incidence of adverse reactions between the two groups was counted and compared.Results(1)The ovulation rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the number of high-quality follicles between the two groups(P>0.05).(2)After 3 cycles of treatment,the levels of FSH and TTE in the two groups were significantly higher than those before treatment(P<0.05),and the levels of E2,LH and basal AMH were significantly lower than those before treatment(P<0.05).There was significant difference in the above indexes between the two groups(P<0.05).(3)After 3 cycles of treatment,the thickness of endometrium in the two groups was significantly greater than that before treatment(P<0.05),and PI and RI were significantly lower than those before t

关 键 词：多囊卵巢综合征 来曲唑 人绝经期促性腺激素 性激素 子宫内膜容受性 抗苗勒管激素 

分 类 号：R711.75[医药卫生—妇产科学]