克罗米芬联合倍美力对无排卵妇女黄体期子宫内膜的影响

The effect of clomiphene citrate and premarin on the histological changes in endometrium of luteal phase in anovulatory women

目的 探讨小剂量雌激素倍美力对克罗米芬诱导排卵黄体期子宫内膜组织学的影响。方法64例无排卵不孕妇女随机分为两组：试验组和对照组，每组各32例。试验组采用克罗米芬联合倍美力治疗，对照组采用克罗米芬治疗。两组均B超监测优势卵泡至排卵，去除无排卵病例，取试验组和对照组各20例，于黄体期取内膜测组织学，雌孕激素受体，测定同期血中雌、孕激索水平。结果实验组子宫内膜组织学异常率为40％明显低于对照组65％，试验组子宫内膜腺上皮ER，PR受体含量明显高于对照组。试验组血雌、孕激索水平（423．54±110．26pmol／L，3．125±0．564ng／L）与对照组（401．23±25．91pmol／L，2．854±0．621ng／L）无差异。结论添加小剂量倍美力能增加克罗米芬诱导排卵时子宫内膜ER、PR表达，而促进子宫内膜发育。

Objective To assess the effect of clomiphene citrate and premarin on the histological changes in endometrium of luteal phase in anovulatory women. Methods Sixty-four women with anovulatory infertility were evenly divided into two groups randomly. CC ＋ premarin treated group and CC treated group. Two groups were determined ovulatory by ultrasonography, anovulatory women were cut off,20 women in each groups were available. Endometrium histology, estrogen receptor and progestin receptor, and the blood levels of estradioll, progesterone were detected. Results The frequency of abnormality of histological changes occurred in research group is 40%, which is lower than the 65% of the control group ; the expression of ER and PR in the epithelium of endometrium in research group were higher than that in the control group （ P 〈 0. 05, P 〈 0.05 ）. There is no significant difference between the two groups in the blood levels of estradioll and progesterone respectively. Conclusion Premarin combined with clomiphene citrate given to women with anovulatory infertility will promote the expressiong of ER and PR in endometrium, therefore stimulate the growth of endometrium.