來曲唑改善多囊卵巢綜合征不孕患者激素水平和排卵情況的療效分析

孫立蘭++葉青+陳艷娥

【摘要】目的：探討來曲唑改善多囊卵巢綜合征不孕患者激素水平和排卵情況。方法：將2012年9月至2014年12月我院收治的96例多囊卵巢綜合征不孕患者隨機分為觀察組和對照組，對照組采用氯米芬治療，觀察組采用來曲唑治療，比較兩組排卵情況及治療前后激素水平。結果：觀察組排卵數及優勢卵泡數明顯多于對照組，排卵率、妊娠率高于對照組，OHSS發生及早期流產發生率低于對照組，差異有統計學意義（P<0.05）；觀察組HCG注射日子宮內膜厚度大于對照組，Insler評分高于對照組，差異有統計學意義（P<0.05）；觀察組治療后LH、FSH、E2水平明顯高于對照組，T低于對照組，差異有統計學意義（P<0.05）。結論：來曲唑有助于多囊卵巢綜合征不孕患者排卵，改善激素水平，可在臨床上推廣。

【關鍵詞】來曲唑； 多囊卵巢綜合征；激素；排卵

Efficacy of letrozloe to improve hormone levels and ovulation in infertile patients with polycystic ovarian syndromeSUN Lilan1， YE Qing1△， CHEN Yane 2. 1.Department of Obstetrics， Shiyan Maternal and Children Healthcare Hospital， Shiyan 442000， Hubei， China； 2. Fangxian Mental Hospital， Shiyan 442100， Hubei， China

【Abstract】Objectives： To investigate the efficacy of letrozloe to improve hormone levels and ovulation in infertile patients with polycystic ovary syndrome. Methods： The 96 infertile patients with polycystic ovarian syndrome in our hospital from September 2012 to December 2014 were randomly divided into the observation group and the control group. Control group received the treatment of clomiphene， while the observation group was given the treatment of letrozloe. The ovulation and hormone levels before and after treatment of two groups were compared. Results： The number of ovulation and dominant follicles of observation group were significantly more than the control group； the ovulation rate and pregnancy rate was higher than the control group； the incidence of OHSS and early abortion rate was lower than the control group， all with statistically significant difference （P<0.05）. The endometrial thickness of observation group at HCG injection day was thicker than the control group， and the Insler score was higher than the control group， both with statistically significant difference （P<0.05）. After treatment， the levels of FSH， E2 and LH in the observation group was significantly higher than the control group， and the T was lower than the control group， both with statistically significant difference （P<0.05）. Conclusion： Letrozloe helps promote ovulation in infertile patients with polycystic ovarian syndrome and improve hormone levels， which can be applied in clinical practice.

【Key words】Letrozloe； Polycystic ovarian syndrome； Hormone； Ovulation

【中圖分類號】R711.75【文獻標志碼】A

多囊卵巢綜合征（polycystic ovarian syndrome， PCOS）是育齡女性月經紊亂的最常見病因，發病率高達5%～10%[1]。PCOS以雄激素過多、慢性無排卵或稀發排卵、卵巢多囊樣改變、胰島素抵抗為主要特征，亦是導致不孕的主要原因之一[2]。目前臨床上主要采用誘發排卵藥克羅米芬治療PCOS導致的不孕癥，雖具有使用方便、價格低廉等優點，但存在強抵抗性、卵巢過度刺激綜合征（OHSS）及多胎妊娠等可能[3]。作為一種第3代芳香化酶抑制劑，來曲唑可阻斷超過90%的芳香化酶活性，通過降低雌激素合成增加促性腺激素分泌，進而促進卵泡發育，有望成為一線排卵藥物。本研究探討來曲唑改善PCOS不孕患者激素水平和排卵情況，旨在為PCOS導致的不孕癥的臨床治療提供參考。現報道如下。endprint

1資料與方法

1.1一般資料

本研究從我院2012年9月至2014年12月收治的多囊卵巢綜合征不孕患者中選取96例作為研究對象，均符合2003年ESHRE/ASRM鹿特丹專家會議推薦的PCOS診斷標準[4]。……