摘要
目的分析多囊卵巢综合征(polycystic ovary syndrome,PCOS)合并不孕患者进行子宫内膜预处理,对其排卵功能和妊娠结局的影响。方法纳入2015年3月—2017年12月临海市第二人民医院收治的100例PCOS合并不孕的患者,按照随机数字表法分为对照组和观察组,每组50例。对照组给予克罗米芬,观察组在给予克罗米芬前,预先服用达英-35联合二甲双胍进行子宫内膜预处理。比较2组治疗前、后的性激素水平[指标:血清促黄体生成素(LH)、促卵泡刺激素(FSH)、睾酮(T)、雌二醇(E2)]和空腹胰岛素(FINS),临床疗效,子宫内膜血流灌注分型、子宫内膜厚度,排卵率和妊娠率。结果治疗后2组患者子宫内膜血流灌注分型(Hc=10.100,P=0.006)、厚度(t=7.203,P<0.001)比较差异均有统计学意义;观察组性激素水平相关指标[LH(t=5.012,P<0.001)、FSH(t=2.088,P=0.037)、T(t=2.360,P=0.018)、E2(t=3.743,P<0.001)]和空腹胰岛素(t=3.442,P=0.001)的改善,均优于对照组。观察组患者的同期排卵率(χ^2=11.600,P=0.001)和妊娠率(χ^2=6.620,P=0.010)均高于对照组。结论 PCOS合并不孕患者经达英-35联合二甲双胍联合用药的预处理,可以改善其血清内相关性激素水平及空腹胰岛素水平,改善子宫内膜容受性,提高排卵率和妊娠率。
Objective To analyze the effect of endometrial pretreatment on ovulation function and pregnancy outcome in infertile women with polycystic ovary syndrome(PCOS).Methods A total of 100 patients with PCOS enrolled in the Second People’s Hospital of Linhai from March 2015 to December 2017 were divided into control group and observation group according to the method of random number table,with 50 cases in each group.The control group was given clomiphene,and the observation group was pretreated with Diane 35 and metformin before clomiphene.Before and after treatment,the levels of sex hormone(serum LH,FSH,T,E2)and fasting insulin level(FINS)were compared between the two groups.Results After treatment,the difference of endometrial blood flow perfusion type(Hc=10.100,P=0.006)and thickness(t=7.203,P<0.001)between the two groups was statistically significant.The improvement of LH(t=5.012,P<0.001),FSH(t=2.088,P=0.037),T(t=2.360,P=0.018),E2(t=3.743,P<0.001)and FINS(t=3.442,P=0.001)in the observation group was better than those in the control group(P<0.05).The cycle ovulation rate(χ^2=11.600,P=0.001)and pregnancy rate(χ^2=6.620,P=0.010)in the observation group were higher than those in the control group(P<0.05).Conclusion The treatment of infertility patients with PCOS can improve the level of serum related hormones and fasting insulin level,thus improve the endometrial receptivity,and improve the ovulation rate and pregnancy rate.
作者
叶娅琼
蒋瑶枝
陈君霞
周静
YE Ya-qiong;JIANG Yao-zhi;CHEN Jun-xia;ZHOU Jing(Department of Obstetrics and Gynecology,the Second People’s Hospital of Linhai,Linhai,Zhejiang 317016,China;不详)
出处
《中华全科医学》
2020年第9期1530-1533,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2018KY822)。
