炔雌醇环丙孕酮片治疗多囊卵巢综合征的诱导排卵功效探讨

Discussion on the induced ovulation efficacy of ethinylestradiol and cyproterone acetate tablets in the treatment of polycystic ovary syndrome

目的探讨应用炔雌醇环丙孕酮片治疗多囊卵巢综合征(PCOS)诱导排卵的临床效果。方法选取桂林市妇幼保健医院2009年5月～2011年10月收治的90例PCOS患者,服用炔雌醇环丙孕酮片治疗4个月经周期,用药前后分别测定患者体质量指数(BMI)、空腹胰岛素(FINS)、雌二醇(E2)、睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、周期排卵率、临床妊娠率。结果 90例患者在服用炔雌醇环丙孕酮片后,其BMI、FINS、T、LH、LH/FSH均低于治疗前,差异具有统计学意义(P<0.05),FSH、E2在治疗前后差异无统计学意义(P>0.05)。所有患者经治疗后其周期排卵率达到83.3%,临床妊娠率达到37.8%。结论应用炔雌醇环丙孕酮片治疗多囊卵巢综合征患者性排卵障碍者,可以降低血糖及高雄激素血症,提高排卵率和临床妊娠率,有效改善患者的临床症状,值得临床推广应用。

Objective To investigate the clinical efficacy of induced ovulation of ethinylestradiol and cyproterone acetate tablets in the treatment of polycystic ovary syndrome （PCOS）. Methods Ninety patients with PCOS of maternal and child health hospital of Guilin City from May 2009 to October 2011 were selected, and taken ethinylestradiol and cyproterone acetate tablets for 4 menstrual cycles. The body mass index （BMI）, fasting insulin （FINS）, estradiol （E2）, testosterone （T）, luteinizing hormone （LH）, follicle stimulating hormone （FSH）, rate of cycle ovulation, clinical pregnancy rate of patients before and after treatment were determined. Results After taking the ethinylestradiol and cyproterone acetate tablets, the BMI, FINS, T, LH, LH/FSH of 90 patients were all lower than before treatment, the differ- ences were statistically significantly different （P 〈 0.05）, while there were no significant differences of FSH, E2 before and after treatment （P 〉 0.05）. After treatment, the rate of cycle ovulation in all patients reached to 83.3%, and the clinical pregnancy rate reached to 37.8%. Conclusion The application of ethinylestradiol and cyproterone acetate tablets in the treatment of ovulation failure in patients with polycystic ovary syndrome can reduce blood sugar and hyperandrogenism, enehance the ovulation rate and clinical pregnancy rate, improve the patients＂ clinical symptoms effectively, which is worthy of clinical application.