本文選題：氯米芬　切入點：來曲唑　出處：《西安交通大學學報(醫(yī)學版)》2017年05期

【摘要】：目的研究氯米芬與來曲唑對多囊卵巢綜合征(polycystic ovarian syndrome,PCOS)促排卵患者子宮動脈及內膜下血流的影響,為提高患者療效提供依據(jù)。方法回顧性分析2014年9月至2016年8月在西安交通大學第一附屬醫(yī)院婦產科就診的PCOS排卵障礙患者198例的臨床資料,根據(jù)促排卵方案不同分為氯米芬組(CC組,102例)、來曲唑組(LE組,96例),比較兩組患者促排卵后子宮動脈及內膜下血流、促排卵率和妊娠率等。結果 (1)兩組患者促排卵后子宮動脈搏動指數(shù)(PI)、阻力指數(shù)(RI)的差異均無統(tǒng)計學意義(t值0.302~1.644,P均0.05),LE組子宮內膜生長速度顯著優(yōu)于CC組(t值3.750~9.573,P均0.05),兩組患者內膜下血流PI無統(tǒng)計學差異(t值0.153~1.042,P均0.05),但LE組促排卵后月經(jīng)第17、19、20天內膜下RI顯著低于CC組(t值分別為2.809、4.776、5.231,P均0.05);(2)比較兩組促排卵成功患者相關數(shù)據(jù)發(fā)現(xiàn),LE組注射hCG日、排卵后5~6d子宮內膜厚度均顯著高于CC組(t值分別為4.839、4.438,P均0.05),且子宮內膜形態(tài)顯著優(yōu)于CC組(χ~2=12.674,P0.05),兩組排卵日、平均優(yōu)勢卵泡直徑、優(yōu)勢卵泡數(shù)、排卵數(shù)、注射hCG日及排卵后5~6d血清雌二醇、孕酮水平比較均無統(tǒng)計學差異(t值0.402~1.234,P均0.05);(3)CC組促排卵成功率為63.73%,LE組促排卵成功率為59.38%,兩組比較無統(tǒng)計學差異(χ~2=0.396,P0.05),LE組生化妊娠率和臨床妊娠率分別為33.33%、27.08%,顯著高于CC組的20.59%、14.71%(χ~2=4.098、4.614,P均0.05);(4)兩組促排卵成功患者注射hCG日、排卵后5~6d子宮動脈PI、RI兩組比較均無統(tǒng)計學差異(t=0.435、0.324、0.564、0.879,P均0.05),且兩組子宮內膜下PI亦無統(tǒng)計學差異(t=0.442、0.490,P均0.05),但子宮內膜下LE組RI均顯著低于CC組(t=3.097、4.036,P均0.05)。結論來曲唑用于PCOS患者促排卵能顯著改善子宮內膜形態(tài)和厚度,使內膜血供增加,容受性好,進而提高妊娠率。
[Abstract]:Objective to study the effects of clomiphene and letrozole on uterine artery and subendometrial blood flow in patients with polycystic ovarian syndrome (PCOS). Methods from September 2014 to August 2016, 198 patients with PCOS ovulation disorder who were admitted to gynecology and obstetrics department of the first affiliated Hospital of Xi'an Jiaotong University were analyzed retrospectively. According to the different ovulation promotion schemes, 102 patients in CC group and 96 patients in letrozole group were divided into two groups. The uterine artery and subendometrial blood flow after ovulation stimulation were compared between the two groups. Results there was no significant difference in uterine artery pulsatility index (Pi) and resistance index (RI) between the two groups. There was no significant difference in endometrial growth rate between the two groups (t = 0.302 ~ 1.644g, P = 0.05LE, P = 3.7509.573P). There was no significant difference in Pi between the two groups. There was no significant difference in Pi between the two groups. However, the RI of subintimal blood flow was significantly lower in le group than that in CC group on day 17, 1920 after ovulation stimulation. The data of patients with successful ovulation promotion were found to be significantly lower than those of CC group (P = 0.052P = 2.809 鹵4.776N 5.231g, P = 0.052respectively). The endometrial thickness was significantly higher than that in CC group (P = 4.839, P = 4.438N, P < 0.05), and the endometrial morphology was significantly better than that in CC group (蠂 ~ (2) 2) 12.674 (P 0.05). The mean dominant follicle diameter, the number of dominant follicles, and the number of ovulation in the two groups were significantly higher than those in CC group on the 6th day after ovulation. Serum estradiol was injected on the day of hCG and 5 days after ovulation. There was no significant difference in progesterone levels between the two groups (P = 0.402 鹵1.234p = 0.05). The success rate of ovulation promotion in CC group was 63.73g / L = 59.38, respectively. There was no significant difference between the two groups (蠂 ~ (2) 0.396N P 0.05LE group's biochemical pregnancy rate and clinical pregnancy rate were 33.333n 27.08, respectively, significantly higher than those in CC group. 20.59: 14.71% (蠂 ~ (2 / 2) 4.098 ~ 4.614). The two groups of patients with successful ovulation promotion were injected with hCG on the day of ovulatory stimulation. There was no statistical difference between the two groups in uterine artery Pi RI on the 6th day after ovulation. There was no statistical difference between the two groups. Conclusion the subendometrial Pi of the two groups is not significantly different from that of the control group (P < 0.05), but the RI of the subendometrial le group is significantly lower than that of the CC group (P < 0.05). Conclusion Letrazole is used in PCOS patients with no significant difference (P < 0.05), but the RI in the subendometrial le group is significantly lower than that in the CC group (P < 0.05). Ovulatory stimulation can significantly improve the endometrial shape and thickness. The blood supply of endometrium is increased, the receptivity is good, and the pregnancy rate is increased.
【作者單位】： 西安交通大學第一附屬醫(yī)院婦產科;
【分類號】：R711.75

【相似文獻】

相關期刊論文 前1條

1 閻樂法,左鳳英,張崇交;人絨毛膜促性腺激素促排卵致甲狀腺機能亢進癥二例報告[J];生殖醫(yī)學雜志;1998年02期

相關會議論文 前1條

1 殷燕云;談勇;周閣;童星麗;陳婕;;中藥調周法對卵巢功能減退促排卵周期結局的影響[A];中國中西醫(yī)結合學會生殖醫(yī)學分會首屆學術年會暨生殖醫(yī)學專業(yè)委員會成立大會論文匯編[C];2014年

，

本文編號：1678044