地屈孕酮联合低剂量阿司匹林治疗PCOS不孕患者的临床效果  

Clinical effect of dydrogesterone combined with low-dose aspirin on infertile patients with polycystic ovary syndrome

作　　者：李荣 何海燕 刘菲 岳娟 付贤玲 李怡 Li Rong;He Haiyan;Liu Fei;Yue Juan;Fu Xianling;Li Yi(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院妇产科,西安710038

出　　处：《中国综合临床》2025年第2期81-87,共7页Clinical Medicine of China

基　　金：陕西省自然科学基金(2023-JC-YB-660)。

摘　　要：目的探讨地屈孕酮联合低剂量阿司匹林治疗多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕患者的效果,及对患者血清激素和辅助性T细胞因子水平的影响。方法选取空军军医大学第二附属医院2018年1月至2023年10月收治的300例PCOS不孕患者。本研究采用前瞻性随机对照研究,采用随机信封法将研究对象分为对照组和观察组,各150例。对照组在常规干预基础上联合地屈孕酮治疗,观察组在对照组治疗基础上联合低剂量阿司匹林治疗。比较两组患者的血清激素水平、辅助性T细胞因子水平、总有效率、3个月妊娠率和不良反应发生率。呈正态分布的计量资料以x¯±s表示,两组间比较采用两独立样本t检验,治疗前后比较采用配对t检验;计数资料以例(%)表示,组间比较采用χ^(2)检验。结果治疗1周期后,两组患者血清促卵泡生成素、黄体生成素水平均低于治疗前,且观察组均低于对照组[(5.27±1.01)U/L比(6.40±1.13)U/L,(6.78±0.87)U/L比(7.16±0.91)U/L,t值分别为9.13、3.70,均P<0.001];两组患者血清雌二醇水平均高于治疗前,且观察组高于对照组[(93.35±8.17)ng/L比(82.45±9.14)ng/L,t=10.89、P<0.001]。治疗后,两组患者血清γ干扰素、白细胞介素2(interleukin,IL-2)、IL-4和IL-6水平均低于治疗前,且观察组均低于对照组[(56.96±4.64)ng/L比(61.36±4.41)ng/L,(38.74±7.43)ng/L比(45.63±8.64)ng/L,(41.03±7.06)ng/L比(43.36±8.12)ng/L,(23.14±4.33)ng/L比(27.14±5.14)ng/L,t=8.42、P<0.001,t=7.40、P<0.001,t=2.65、P=0.008,t=7.29、P<0.001]。观察组总有效率和3个月妊娠率均高于对照组[86.0%(129/150)比74.7%(112/150),63.3%(95/150)比47.3%(71/150),χ^(2)=6.10、P=0.014,χ^(2)=6.73、P=0.010]。观察组不良反应发生率与对照组比较差异无统计学意义[12.7%(22/150)比9.3%(14/150),χ^(2)=0.85,P=0.356]。结论地屈孕酮联合低剂量阿司匹林治疗PCOS不孕患者临床效果显著,可有效调节患者的血清激素、辅助�ObjectiveTo investigate the effect of low-dose aspirin combined with dydrogesterone in the treatment of patients with polycystic ovary syndrome(PCOS)complicated with infertility and its influence on hormones and helper T cytokines.Methods300 PCOS patients with infertility in the Second Affiliated Hospital of Air Force Military Medical University were selected from January 2018 to October 2023.A prospective randomized controlled study was performed.The study subjects were divided into control group and observation group by random envelope method,with 150 cases in each group.The control group was treated with dydrogesterone on the basis of routine intervention,while the observation group was combined with low-dose aspirin on the basis of the control group.The efficacy,pregnancy rate,hormones,Th1 and Th2 cytokines and incidence of adverse reactions were compared in between groups.Measurement data with normal distribution was represented by x¯±s.Comparison between groups was performed by two-sample t-test and paired t-test was used for comparison before and after treatment.Enumeration data was represented by n(%).Comparison between groups was performed byχ^(2) test.ResultsAfter treatment,the total effective rate of treatment and pregnancy rate in observation group were higher than those in control group[86.00%(129/150)vs.74.67%(112/150),63.33%(95/150)vs.47.33%(71/150)](χ^(2)=6.10,P=0.014,χ^(2)=6.73,P=0.010).Serum levels of follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in both groups were lower after treatment than those before treatment,and the levels in observation group were lower than those in control group[(5.27±1.01)U/L vs.(6.40±1.13)U/L,(6.78±0.87)U/L vs.(7.16±0.91)U/L],and serum estradiol level was higher than that before treatment,and the level in observation group was higher compared to control group[(93.35±8.17)ng/L vs.(82.45±9.14)ng/L](t=9.13,3.70,10.89,all P<0.001).After treatment,serumγ-interferon,interleukin(IL-2),IL-4 and IL-6 levels were all lower in both groups than those be

关 键 词：多囊卵巢综合征 不孕 阿司匹林 地屈孕酮 

分 类 号：R711.6[医药卫生—妇产科学]