炔雌醇環(huán)丙孕酮聯(lián)合來曲唑治療多囊卵巢綜合征的效果

謝文玲　胡秋　陳萍

【摘要】 目的：探討炔雌醇環(huán)丙孕酮聯(lián)合來曲唑治療多囊卵巢綜合征（PCOS）的效果。方法：選擇筆者所在醫(yī)院門診2017年7月-2019年12月182例PCOS患者為研究對象，隨機分為對照組（n=91）和觀察組（n=91）。對照組采用炔雌醇環(huán)丙孕酮治療，觀察組在對照組基礎(chǔ)上聯(lián)合來曲唑治療。比較兩組治療效果、激素水平及預(yù)后情況。結(jié)果：觀察組治療總有效率為96.70%，高于對照組的71.43%（P<0.05）。兩組治療后FSH水平高于治療前（P<0.05）;LH、LH/FSH水平及T水平低于治療前（P<0.05）;觀察組治療后FSH水平高于對照組（P<0.05）;LH、LH/FSH水平及T水平低于對照組（P<0.05）。兩組卵巢過度刺激綜合征發(fā)生率比較，差異無統(tǒng)計學(xué)意義（P>0.05），觀察組治療后周期妊娠率高于對照組（P<0.05），卵巢黃素化綜合征、流產(chǎn)發(fā)生率低于對照組（P<0.05）。結(jié)論：炔雌醇環(huán)丙孕酮聯(lián)合來曲唑用于PCOS患者的治療中，可提高治療效果，改善性激素水平，獲得良好的預(yù)后，值得推廣應(yīng)用。

【關(guān)鍵詞】 炔雌醇環(huán)丙孕酮 來曲唑 多囊卵巢綜合征 性激素水平 預(yù)后

doi：10.14033/j.cnki.cfmr.2020.16.016 文獻標(biāo)識碼 B 文章編號 1674-6805（2020）16-00-03

Ethinyl Estradiol Cyproterone Combined with Letrozole in the Treatment of Patients with Polycystic Ovary Syndrome/XIE Wenling， HU Qiu， CHEN Ping. //Chinese and Foreign Medical Research， 2020， 18（16）： -43

[Abstract] Objective： To investigate the effect of Ethinyl Estradiol Cyproterone combined with Letrozole in the treatment of patients with polycystic ovary syndrome （PCOS）. Method： A total of 182 PCOS patients with from July 2017 to December 2019 in the outpatient clinic of our hospital were selected and randomly divided into the control group （n=91） and the observation group （n=91）. The control group was treated with Ethinyl Estradiol and Cyproterone， and the observation group was combined with Letrozole treatment on the basis of the control group. Compared the treatment effect， hormone levels and prognosis of the two groups. Result： The total effective rate of treatment in the observation group was 96.70%， higher than 71.43% in the control group （P<0.05）. The FSH levels after treatment in both groups were higher than those before treatment （P<0.05）. The LH， LH/FSH levels and T levels were lower than those before treatment （P<0.05）. The FSH level in observation group after treatment was higher than that of the control group （P<0.05）. LH， LH /FSH level and T level were lower than those of the control group （P<0.05）. There was no statistically significant difference in the incidence of syndromes of ovarian hyperstimulation between the two groups （P>0.05）. The period pregnancy rate of the observation group after treatment was higher than that of the control group （P<0.05）. The incidence of ovarian luteinization syndrome and miscarriage were lower than those of the control group （P<0.05）. Conclusion： Ethinyl estradiol cyproterone combined with letrozole can increase the treatment effect， improve the sex hormone levels in PCOS， and can obtain a good prognosis， which is worthy of popularization and application.

[Key words] Ethinyl Estradiol Cyproterone Letrozole Polycystic ovary syndrome Ultrasound indexes Sex hormone levels Prognosis

First-authors address： Shenzhen Longhua District Peoples Hospital， Shenzhen 518109， China

多囊卵巢綜合征（polycystic ovary syndrome，PCOS）是生育年齡婦女較為常見的一種復(fù)雜的內(nèi)分泌、代謝異常引起的疾病，臨床上以慢性無排卵及高雄激素血癥為主要特征，臨床多表現(xiàn)為月經(jīng)周期不規(guī)律、多毛、不孕等，影響患者健康、生活[1]。國內(nèi)學(xué)者研究表明：PCOS病因復(fù)雜，可能與部分基因在特定環(huán)境因素作用下引起的疾病有關(guān)，且臨床上形成非遺傳學(xué)理論及遺傳學(xué)理論兩種[2]。炔雌醇環(huán)丙孕酮屬于是一種復(fù)方制劑，屬于口服類避孕藥的一種，具有抗雄性激素、抗促性腺激素作用，能加快雄性激素代謝，降低雄性激素水平，能為卵巢排卵營造良好的激素水平環(huán)境[3]。來曲唑?qū)儆谑切乱淮枷慊敢种苿瑸槿斯ず铣傻钠S三唑類衍生物，能降低雌激素水平，消除雌激素對腫瘤生長的持續(xù)刺激作用[4]。因此，本研究以PCOS患者為對象，探討炔雌醇環(huán)丙孕酮聯(lián)合來曲唑在PCOS患者中的效果，現(xiàn)報道如下。

1 資料與方……