低分子肝素钙联合来曲唑治疗多囊卵巢综合征不孕症的效果  

Effect of Low-Molecular-Weight Heparin Calcium Combined with Letrozole on the Treatment of Polycystic Ovary Syndrome-Induced Infertility

作　　者：张瑜[1] 马丽影[1] ZHANG Yu;MA Liying(Department of Reproductive Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院生殖医学部,河南郑州450003

出　　处：《河南医学研究》2025年第8期1497-1500,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230319)。

摘　　要：目的 研究低分子肝素钙联合来曲唑治疗多囊卵巢综合征(PCOS)不孕症效果及对子宫内膜容受性、内分泌指标及妊娠结局的影响。方法 将2021年2月至2023年3月在郑州大学第二附属医院生殖医学部就诊的82例多囊卵巢综合征不孕症患者随机分为对照组和试验组,对照组接受来曲唑治疗,试验组接受低分子肝素钙联合来曲唑治疗。比较两组临床治疗效果及对妊娠结局的影响。结果 经过3个月的治疗后,试验组总有效率为92.68%,高于对照组总有效率的73.17%(P<0.05)。试验组患者促卵泡素(FSH)、雌二醇(E 2)较高,黄体生成素(LH)较低(P<0.05)。试验组患者子宫内膜厚度指标较高,子宫螺旋动脉阻力、子宫螺旋动脉搏动指数指标较低(P<0.05)。试验组患者血清Kisspeptin水平下降幅度较大(P<0.05)。试验组患者妊娠率(26.82%)、排卵率(75.61%)均高于对照组(14.63%、53.65%)(P<0.05)。试验组患者不良反应发生率(17.07%)低于对照组(19.51%),但差异无统计学意义(P>0.05)。结论 临床通过低分子肝素钙联合来曲唑治疗PCOS不孕症有较好疗效,可调节患者性激素水平,改善患者子宫情况,增加内膜厚度,提高患者排卵率和妊娠率,且联合用药不会增加不良反应,是一种较好的临床治疗手段。Objective To study the effect of low-molecular-weight heparin calcium combined with letrozole on the treatment of infertility caused by polycystic ovary syndrome(PCOS)and its impact on endometrial receptivity,endocrine indicators,and pregnancy outcomes.Methods A total of 82 patients diagnosed with polycystic ovary syndrome(PCOS)-related infertility at the Department of Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University from February 2021 to March 2023 were randomized into two groups:the control group(letrozole monotherapy)and the experimental group(letrozole combined with low-molecular-weight heparin calcium).Therapeutic efficacy,and pregnancy outcomes were comparatively analyzed.Results After 3 months of treatment,the total effective rate of the experimental group was 92.68%,higher than that of the control group(73.17%)(P<0.05).The experimental group showed higher levels of follicle-stimulating hormone(FSH)and estradiol(E 2),and lower levels of luteinizing hormone(LH)(P<0.05).The endometrial thickness index was higher in the experimental group,while the uterine spiral artery resistance and pulsatility index were lower(P<0.05).The experimental group exhibited a greater decrease in serum Kisspeptin levels(P<0.05).The pregnancy rate(26.82%)and ovulation rate(75.61%)of the experimental group were higher than those of the control group(14.63%,53.65%)(P<0.05).The incidence of adverse reactions in the experimental group(17.07%)was lower than that in the control group(19.51%),but the difference was not statistically significant(P>0.05).Conclusion The combination of low molecular weight heparin and letrozole for the treatment of PCOS infertility has good therapeutic effects.It can regulate the hormone levels of patients,improve the uterine condition,increase the thickness of the endometrial layer,increase the ovulation rate and pregnancy rate of patients,and the combined treatment will not increase the incidence of adverse reactions,which is a better clinical treatment method.

关 键 词：多囊卵巢综合征 低分子肝素钙 来曲唑 子宫内膜容受性 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]