氯米芬与来曲唑在多囊卵巢综合征不孕患者中促排卵作用比较被引量：42

Comparison of the efficacy between clomiphene citrate and letrozole on ovulation induction in infertile patients with polycystic ovary syndrome

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摘要目的探讨枸橼酸氯米芬(CC)和来曲唑(LE)在多囊卵巢综合征(PCOS)不孕患者中促排卵的作用。方法选择2014年1月至2015年12月在上海市沃德医疗中心就诊的PCOS不孕患者,随机分为研究组(n=120)和对照组(n=115)。研究组和对照组分别在月经第3天开始应用LE 5 mg和CC 100 mg促排卵,应用5 d后停药,并在至少一个卵泡直径达20 mm时注射10 000 IU的h CG。比较两组患者直径≥14 mm卵泡(优势卵泡)数、直径≥18 mm卵泡数及注射h CG时子宫内膜厚度、促排卵后内分泌指标、周期妊娠率等。结果研究共纳入235例PCOS患者,给予LE促排卵(研究组)的120例中,39例妊娠,周期妊娠率为32.5%,给予CC促排卵(对照组)的115例中,15例妊娠,周期妊娠率为13.0%,两组间比较差异有统计学意义(P<0.01)。注射h CG时,对照组子宫内膜厚度(9.4±0.2)mm,高于观察组的(8.0±0.3)mm,差异有统计学意义(P<0.05)。促排卵后,对照组组患者的血清雌激素、孕激素和黄体生成素水平均高于观察组,而FSH水平和AMH水平低于观察组,差异均有统计学意义(P<0.05)。结论与对照组比较,应用LE对PCOS不孕患者进行促排卵治疗,对子宫内膜影响小,周期妊娠率高。 Objective To compare the efficacy of clomiphene（ CC） and letrozole（ LE） on ovulation induction in infertile of polycystic ovary syndrome（ PCOS） . Methods Infertile women with polycystic ovary syndrome（ PCOS） who visited Worldpath Clinic International were randomized to treatment with 5 mg of letrozole daily or 100 mg clomiphene daily for 5 days,respectively,starting on 3rd day of menses,and were injected 10000 IU hCG in at least one follicle with a diameter of 20 mm. The number of follicle≥14 mm,number of follicle≥18 mm,thickness of endometrium on day of hCG injection,endocrine index and rate of period pregnancy were compared be-tween the two groups. Results The study comprised a total of 235 patients,including 120 in LE group and 115 in CC group. The peri-od pregnancy rate was 32. 5% in LE group and 13. 0% in CC group,with a significant difference between two groups（P〈0. 01）. The thickness of endometrium on day of hCG injection in CC group was significantly higher than that in LE group（P〈0. 05）. After ovula-tion induction,the level of serum estrogen, progesterone and LH in CC group were significantly higher than that in LE group （ P 〈0. 05）,while the level of FSH and AMH in CC group were significantly lower than that in LE group（P〈0. 05）. Conclusion In ovu-lation induction of PCOS,LE has less impact on endometrium and better efficacy on period pregnancy rate than CC.

作者刘岚朱昊平

机构地区上海市沃德医疗中心

出处《临床军医杂志》 CAS 2016年第4期343-346,共4页 Clinical Journal of Medical Officers

关键词氯米芬来曲唑多囊卵巢综合征促排卵 Letrozolez Clomiphene Polycystic ovary syndrome Ovulation induction

分类号 R711 [医药卫生—妇产科学]

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参考文献14

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