摘要
目的探讨妈富隆(地索高诺酮+乙炔雌二醇)与芳香化酶抑制剂来曲唑序贯用药对多囊卵巢综合征患者内分泌及生殖功能的影响。方法150例多囊卵巢综合征患者口服妈富隆3个周期后,随机分为3组,来曲唑组50例,氯米芬组50例,来曲唑与氯米芬联合用药组50例;52例月经正常的育龄妇女作为对照组。记录4组排卵率、妊娠率以及月经周期的卵泡中期、围排卵期、黄体中期血清生殖激素浓度。结果①150例多囊卵巢综合征患者停用妈富隆后,血清睾酮水平和卵巢窦状卵泡数目均较用药前降低,t值分别为21.37、38.22,P<0.05;②来曲唑组、氯米芬组、来曲唑与氯米芬联合用药组和对照组排卵率,分别为82.00%、79.59%、84.00%和94.23%,P>0.05,用药后3组妊娠率分别为22.00%、12.24%和14.00%,比较无显著性差异(P>0.05);③黄体中期雌二醇水平来曲唑组大于氯米芬组,t=2.44,P<0.05;④围排卵期超声显示,来曲唑组子宫内膜厚度与联合用药组相似(t=0.49,P>0.05),均大于氯米芬组,t分别为3.71、3.16,P<0.05;A型子宫内膜比例:来曲唑组与对照组相似,大于氯米芬组(2χ=7.62,P<0.01);宫颈暗区前后径:来曲唑组与对照组相似,大于联合用药组(t=3.63,P=0.001),联合用药组大于氯米芬组(t=2.30,P=0.026)。结论妈富隆与来曲唑序贯用药促进多囊卵巢综合征患者排卵。
Objective To observe effects of marvelon( desogestrel and ethinyl estradiol) and aromatase inhibitor letrozole sequential therapy on endocrine functions and fertility of women with polycystic ovary syndrome (PCOS). Methods After administration of marvelon for three cycles, a total of 150 infertile women with PCOS were randomly divided into 3 groups: letrozole group( n = 50), clomiphene citrate (CC) group ( n =50) and etrozole and CC combination group( n =50). 52 women of childbearing age with normal menstruation were as controls. The women with PCOS in the letrozole group received 2.5rag of letrozole, those women with PCOS in the CC group received 50rag of CC and those women with PCOS in the letrozole and CC combination group received 2.5rag of letrozole and 50rag of CC once per day for 5 days from 5th - 9th of their menstrual cycle. And those normal control women didn' t receive any drugs. 10 000 IU of human chorionic gonadotrophin (hCG) was administered when at least one follicle' s mean diameter ≥ 18mm observed by transvaginal ultrasonography. For all women, the ovulation rate, pregnancy rate were recorded and levels of serum estradiol (E2 ) and progesterone (P) were detected, numbers of follicle were counted and endometrial thickness was measured at menstrual cycle day 10( middle follicular phase), the day of hCG administration (periovulatory period) and middle luteal phase. Results ①After marvelon withdrawal, serum level of testosterone(T) of all women with PCOS was lowered and numbers of antral follicles in two ovaries were decreased ( t = 21.37, 38.22, respectively, both P 〈 0.05 ) ; ②Ovulation rate and pregnancy rate were similar in the four groups ( 82.00%, 79.59%, 84.00% and 94.23 %, respectively, all P 〉0.05), and there were no significant differences in ovulation rate between the three administration groups(22.00%, 12.24% and 14.00%, respectively, all P 〉 0.05 ) ; ③Level of E2 in middle luteal phase was significantly higher in the letrozole group than that in the CC group ( t = 2.44, P 〈 0.05 ) ; ④Ultrasonography showed that in the periovulatory period endometrial thickness in the letrozole group was similar to that in the letrozole and CC combination group( t = 0.49, P 〉 0.05 ), but they were more thicker than that in the CC group ( t = 3.71, 3.16, respectively, both P 〈0.01 ) ; the proportion of type A endometria in the letrozole group was similar to that in the control group but they were greater than that in the CC group(x2 = 7.62, P 〈 0.01 ), and anteroposterior diameter of echofree space in cervix in the letrozole group was similar to that in the control group, but they were both greater than those in the letrozole and CC combination group (t =3.63, P=0.001) and the latter was greater than that in the CC group in turn (t =2.30, P =0. 026). Conclusion Marvelon and letrozole sequential therapy could promote ovulation of women with PCOS.
出处
《中国妇幼健康研究》
2008年第2期107-109,共3页
Chinese Journal of Woman and Child Health Research
基金
陕西省科技攻关资助项目(2005K12g5)
关键词
多囊卵巢综合征
地索高诺酮
芳香化酶抑制荆来曲唑
氯米芬
polycystic ovarian syndrome (PCOS)
desogestrel
aromatase inhibitor letrozole
clomiphene citrate (CC)