治疗多囊卵巢综合症40例临床分析

A clinical study of40women with polycystic ovary syndrome

目的:了解对pcos患者据不同临床表现采用不同前期治疗效果及GnRH-a超短方案促排卵及妊娠情况。方法:分两组:Ⅰ 组,肥胖pcos以INS分泌异常为主;Ⅱ组,非肥胖pcos,以LH分泌异常为主。前者采用减重+二甲双胍+安替舒通(SPA)行前期治疗;后者采 用含有E、P激素药物+SPA治疗。两组均连续治疗3个月经周期,当生化代谢及内分泌检查恢复正常采用GnRH-a超短方案促排+指导同 房。结果:Ⅰ、Ⅱ两组通过不同的前期治疗,血生化及内分泌检查,比用药前有明显的差异;GnRH-a超短方案促排卵,Ⅰ、Ⅱ组总妊娠率分别 为37.5%、31.25%,比以往有所提高。结论:(1)减重+二甲双胍+SPA治疗肥胖型pcos效果显著;(2)应用含有E、P激素药物+SPA治疗非 肥胖型pcos效果显著;(3)在前期治疗的基础上,GnRH-a超短方案不失为一个较好的促排卵方案,可提高妊娠率。

Objective:To investigate the results of PCOS(polycystic ovary syndrome)patients using different pretreatments and pregnant rates after induced ovulation with GnRH-a ultro-short protocol.Methods:The study was carried out in40women PCOS grouped as obese characterized by abnormal insulin secretion and nonobese characterized by abnormal LH secretion.The obese patients used bantingism,melbine and SPA,the nonobese patients used oral contraceptive and SPA for pretreatment.After three menstrual cycles therapy,when biochemical indexes and endocrine hormone were normal,all patients were induced ovulation with GnRH-a ulˉtro-short protocol and instructed sexual intercourse.Results:The biochemical indexes and endocrine hormone were significantly imˉproved after three menstrual cycles therapy.The pregnant rates in two groups were37.5%and31.25%respectively,were higher than previous reports.Conclusions:①Treatment with bantingism,melbine and SPA was significantly efficient to obese patients.②Treatment with oral contraceptive and SPA was significantly efficient to nonobese patients.③GnRH-a ultro-short protocol was a better ovulation induction method and a higher pregnant rate was obtained.