低分子肝素钙联合二甲双胍对肥胖PCOS不孕患者血清性激素水平及子宫内膜容受性的影响  

Effects of low molecular weight heparin calcium combined with metformin on serum sex hormone levels and endometrial receptivity in obese PCOS infertile patients

作　　者：刘洋[1] 樊天云[1] LIU Yang;FAN Tianyun(Obstetrics and Gynecology Department,Nanyang First People's Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第一人民医院产二科,河南南阳473000

出　　处：《中国医学工程》2025年第3期53-57,共5页China Medical Engineering

摘　　要：目的 研究肥胖多囊卵巢综合征(PCOS)不孕患者采用低分子肝素钙联合二甲双胍治疗的效果及对血清性激素水平、子宫内膜容受性的影响。方法 回顾性分析2019年1月至2022年1月南阳市第一人民医院96例肥胖型PCOS患者资料,按不同治疗方案分为对照组和观察组,各48例。对照组接受二甲双胍治疗,观察组接受低分子肝素钙+二甲双胍治疗,比较两组临床疗效、子宫内膜容受性[搏动指数(PI)、子宫内膜厚度、阻力指数(RI)]、性激素[黄体生成素(LH)、雌二醇(E2)、促卵泡生成素(FSH)]、凝血功能[D-二聚体(D-D)、凝血酶原活动度(PTA)、纤维蛋白原(FIB)]、促排卵结局及不良反应。结果 观察组临床总有效率(91.67%)高于对照组(75.00%)(P<0.05);治疗后,观察组子宫内膜厚度大于对照组,PI、RI水平低于对照组(P<0.05);与对照组相比,治疗后观察组LH、FSH较低,E2较高(P<0.05);与治疗前比较,两组D-D、PTA、FIB均升高,且观察组更为显著(P<0.05);观察组妊娠率(58.33%)高于对照组(37.50%)(P<0.05);观察组排卵率、自然流产率、不良反应发生率(95.83%、4.17%、10.42%)与对照组(85.42%、8.33%、8.33%)比较,差异无统计学意义(P>0.05)。结论 低分子肝素钙联合二甲双胍治疗肥胖型PCOS疗效显著,可调节性激素水平,提高子宫内膜容受性,改善患者凝血功能,提高妊娠率,安全性高。【Objective】To investigate the effects of low molecular weight heparin calcium combined with metformin on serum sex hormone levels and endometrial receptibility in obese polycystic ovary syndrome(PCOS)infertile patients.【Methods】The data of 96 obese PCOS patients in Nanyang First People's Hospital from January 2019 to January 2022 were retrospectively analyzed,and they were divided into a control group(receiving metformin treatment)and an observation group(receiving low molecular weight heparin calcium plus metformin treatment)according to different treatment plans,48 cases in each group.The clinical efficacy,endometrial receptivity[pulsatility index(PI),endometrial thickness,resistance index(RI)],sex hormones[luteinizing hormone(LH),estradiol(E2),follicle-stimulating hormone(FSH)],coagulation function[D-dimer(D-D),prothrombin activity(PTA),fibrinogen(FIB)],ovulation stimulating outcome and adverse reactions were compared between the two groups.【Results】The total effective rate of the observation group(91.67%)was higher than that of the control group(75.00%)(P<0.05).After treatment,the endometrial thickness in the observation group was thicker than that in the control group,and the PI and RI levels were lower than those in the control group(P<0.05).Compared with the control group,LH and FSH were lower and E2 was higher in the observation group after treatment(P<0.05).Compared with before treatment,D-D,PTA and FIB were increased in both groups,and the observation group was more significant(P<0.05).The pregnancy rate of the observation group(58.33%)was higher than that of the control group(37.50%)(P<0.05).There were no significant differences in ovulation rate,spontaneous abortion rate and adverse reaction rate between the observation group and the control group(95.83%,4.17%,10.42%vs.85.42%,8.33%,8.33%)(P>0.05).【Conclusion】Low molecular weight heparin calcium combined with metformin in the treatment of obese PCOS is effective,and can regulate the level of sex hormone,improve endometrial receptivity,i

关 键 词：肥胖 多囊卵巢综合征 低分子肝素钙 二甲双胍 子宫内膜容受性 性激素 

分 类 号：R711.7[医药卫生—妇产科学]