来曲唑联合氯米芬与来曲唑联合尿促性腺激素治疗多囊卵巢综合征不孕患者的疗效比较  

Comparison of efficacy of letrozole combined with clomiphene and letrozole combined with urinary gonadotropin in treatment of infertility patients with polycystic ovary syndrome(PCOS)

作　　者：朱铮[1] 毛利云[1] 王屹雯 ZHU Zheng;MAO Liyun;WANG Yiwen(Department of Gynecology,Wuxi Hospital of Traditional Chinese Medicine,Wuxi Jiangsu 214071,China)

机构地区：[1]无锡市中医医院妇科,江苏无锡214071

出　　处：《新疆医科大学学报》2025年第2期190-194,202,共6页Journal of Xinjiang Medical University

基　　金：江苏省卫生健康委员会科研计划项目(YN2020071)。

摘　　要：目的探讨来曲唑联合氯米芬或尿促性腺激素(HMG)对多囊卵巢综合征(PCOS)不孕患者血清炎症因子、氧化应激指标的影响及疗效的比较。方法研究对象为2022年3月-2024年3月于无锡市中医医院诊治的100例PCOS患者。依据随机数字表的方法,将所有患者均匀地随机分配为观察组和对照组,各为50例。观察组患者采用来曲唑联合氯米芬治疗,对照组患者采用来曲唑联合HMG治疗。比较两组患者血清卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)和黄体生成素(LH)、白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、血清超氧化物歧化酶(SOD)、总抗氧化能力(T-AOC)及还原性谷胱甘肽(GSH)水平和两组间的妊娠率差异;使用Pearson相关分析治疗后各指标的相关性。结果与治疗前比较,两组患者治疗后的FSH、E2、T-AOC、SOD和GSH显著上升,T、LH、IL-6、CRP和TNF-α显著下降,差异有统计学意义(P<0.05)。与对照组比较,观察组患者治疗后的E2、IL-6及TNF-α显著降低,T-AOC、SOD和GSH显著升高,差异有统计学意义(P<0.05)。两组妊娠率比较差异无统计学意义(χ^(2)=3.026,P=0.145)。治疗后,相较于未妊娠患者,妊娠患者的IL-6和TNF-α水平显著下降,而SOD和GSH水平明显上升,差异有统计学意义(P<0.05)。治疗后,所有患者的FSH、E2与分别与IL-6、TNF-α呈负相关,与GSH呈正相关(P<0.05),而T、LH与血清炎症因子和氧化应激指标间均无相关性(P>0.05)。结论来曲唑联合应用HMG提升PCOS患者E2的效果更佳,而来曲唑联合应用氯米芬改善患者血清炎症因子和氧化应激指标的效果更好。Objective To investigate the effects of letrozole combined with clomiphene or human menopausal gonadotrophin(HMG)on polycystic ovarian syndrome,the effects of serum inflammatory factors and oxidative stress indexes in infertility patients with polycystic ovary syndrome(PCOS).Methods The study subjects were 100 PCOS patients treated in the Hospital from March 2022 to March 2024.According to the method of random number table,all patients were evenly randomly assigned to the observation group and control group,with 50 cases each.Observation group was treated with letrozole combined with clomiphene,control group was treated with letrozole combined with HMG.Before and after the treatment,serum follicle stimulating hormone(FSH),estradiol(E2),testosterone(T),luteinizing hormone(LH),interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),serum superoxide dismutase(SOD),total antioxidant capacity(T-AOC)and reducing glutathione(GSH)were measured in all patients.Chi-square test was used to compare the difference in pregnancy rate between the 2 groups.Pearson correlation was used to analyze the correlation of each index after the treatment.Results Compared with before the treatment,FSH,E2,T-AOC,SOD and GSH in the 2 groups were significantly increased after the treatment,while T,LH,IL-6,CRP and TNF-αwere significantly decreased,with statistical significance(P<0.05).Compared with control group,E2,IL-6 and TNF-αin observation group after the treatment were significantly decreased,while T-AOC,SOD and GSH were significantly increased,with statistical significance(P<0.05).There was no significant difference in pregnancy rate between the 2 groups(χ^(2)=3.026,P=0.145).After the treatment,the levels of IL-6 and TNF-αin pregnant patients were significantly decreased,while the levels of SOD and GSH were significantly increased,with statistical significance(P<0.05).After the treatment,FSH and E2 were negatively correlated with IL-6 and TNF-α,respectively,and positively correlated with GSH(P<0.05),while T and LH

关 键 词：多囊卵巢综合征 性激素 炎症因子 氧化应激 

分 类 号：R711[医药卫生—妇产科学]