来曲唑与克罗米芬单用与联合治疗对多囊卵巢综合征患者血清25-羟维生素D及妊娠率的影响  

Comparison of the Effects of Letrozole and Clomiphene on Serum 25-hydroxyvitamin D and Pregnancy Rate in Patients with Polycystic Ovary Syndrome

作　　者：黄小红 邓淑红 张蕾 HUANG Xiaohong;DENG Shuhong;ZHANG Lei(Xiamen Hongai Maternity Hospital,Xiamen 361000,China)

机构地区：[1]厦门弘爱妇产医院,福建厦门361000

出　　处：《中国医药指南》2023年第19期126-128,共3页Guide of China Medicine

摘　　要：目的探讨来曲唑与克罗米芬单用与联合治疗对多囊卵巢综合征患者血清25-羟维生素D及妊娠率的影响。方法选取2019年1月至2022年12月我院治疗的多囊卵巢综合征患者共计60例为本组研究对象,以患者治疗药物的差异将其分为3组:来曲唑组(20例,单独用来曲唑治疗)、克罗米芬组(20例,单独用克罗米芬治疗)与联合组(20例,采用来曲唑与克罗米芬联合治疗),比较3组多囊卵巢综合征患者妊娠结局(排卵率、流产率和妊娠率)、血清25-羟维生素D水平改善情况、控制性超排卵情况和性激素水平(血清促黄体生成素、睾酮、促卵泡刺激素)改善情况。结果对比3组多囊卵巢综合征患者妊娠结局显示,来曲唑组与克罗米芬组在排卵率、流产率、妊娠率等妊娠结局和促性腺激素时间、促性腺激素用量、HCG子宫内膜厚度方面相比无显著差异(P均>0.05),而联合组在排卵率、流产率和妊娠率等妊娠结局和促性腺激素时间、促性腺激素用量、HCG子宫内膜厚度以及控制性超排卵方面显著优于来曲唑组与克罗米芬组(P均<0.05);3组患者治疗前血清25-羟维生素D水平和血清促黄体生成素、睾酮、促卵泡刺激素等性激素水平相比均无显著差异(P均>0.05),治疗后3组患者以上指标均显著改善(P均<0.05),且联合组血清25-羟维生素D水平和血清促黄体生成素、睾酮、促卵泡刺激素等性激素水平改善情况显著优于来曲唑组与克罗米芬组(P均<0.05),但来曲唑组与克罗米芬组组间比较差异不显著(P均>0.05)。结论来曲唑与克罗米芬单用治疗多囊卵巢综合征均可以取得一定的效果,且两种药物疗效比较差异较小,而两种药物联合治疗可明显提升疗效,尤其是在患者血清25-羟维生素D的改善上和妊娠率的提升方面疗效更为显著。Objective To investigate the effects of letrozole and clomiphene alone and in combination on serum 25-hydroxyvitamin D and pregnancy rate in patients with polycystic ovarian syndrome.Methods A total of 60 patients with polycystic ovarian syndrome who were treated in our hospital from January 2019 to December 2022 were selected as the subjects of this study.According to the differences in the treatment drugs of patients,they were divided into three groups:letrozole group(20 cases,treated with trazole alone),clomiphene group(20 cases,treated with clomiphene alone)and combination group(20 cases,treated with letrozole and clomiphene alone).The pregnancy outcome(indicators include ovulation rate,abortion rate and pregnancy rate),the improvement of serum 25-hydroxyvitamin D level,controlled ovarian hyperstimulation and the improvement of sex hormone level(indicators include serum luteinizing hormone,testosterone,follicle-stimulating hormone)were compared among the three groups of patients with polycystic ovary syndrome.Results Comparing the pregnancy outcomes of the three groups of PCOS patients,there was no significant difference between letrozole group and clomiphene group in ovulation rate,abortion rate and pregnancy rate,gonadotropin time,gonadotropin dosage,HCG endometrial thickness and controlled ovarian hyperstimulation(P>0.05),while the combined group had no significant difference in ovulation rate,abortion rate and pregnancy rate,pregnancy outcome and gonadotropin time the dosage of gonadotropin,the thickness of HCG endometrium and controlled ovarian hyperstimulation were significantly better than those of letrozole group and clomiphene group(P<0.05).There was no significant difference between the levels of serum 25-hydroxyvitamin D and serum luteinizing hormone,testosterone,follicle-stimulating hormone and other sexual hormones in the three groups before treatment(P>0.05).After treatment,the above indicators in the three groups were significantly improved(P<0.05),and the levels of serum 25-hydroxyvitamin D an

关 键 词：多囊卵巢综合征 来曲唑 克罗米芬 联合 血清25-羟维生素D 妊娠率 

分 类 号：R711.75[医药卫生—妇产科学]