丙氨瑞林诱导排卵对预防OHSS的作用

Effect of Alarelin in Preventing OHSS for Triggering Ovulation

目的：探讨丙氨瑞林代替hCG诱导排卵预防卵巢过度刺激综合征（OHSS）的临床应用。方法：分析WHOII型无排卵患者333个超促排卵周期，患者均于月经周期第3～5日开始口服克罗米芬（CC）50mg，qd×5d；或来曲唑（LE）2．5mg，qd×5d，月经第8～10日开始肌肉注射hMG至hCG注射日。阴道B超下显示≤2个优势卵泡者纳入A组，肌肉注射hCG10000U：≥3个优势卵泡者纳入B组，当日肌肉注射丙氨瑞林0。15～0．45mg；排卵后均给予黄体支持并指导同房。结果：A组186个周期，B组147个周期，A、B组间轻度OHSS发生率（8．1％vs2．7％）、中度OHSS发生率（3．2％vs1．4％）以及排卵率（88．7％vs95．2％）、临床妊娠率（21．0％vs34．8％）均有显著性差异（P〈0．05），但流产率（15．4％VS18．8％）差异无统计学意义（P〉0．05）。结论：丙氨瑞林代替hCG诱发排卵可有效降低OHSS发生率，并使排卵率以及临床妊娠率明显提高。

Objective： To explore the effect of alarelin in preventing ovarian hyperstimulation syndrome （OHSS） for triggering ovulation. Methods： A total of 333 cycles of WHO Ⅱ non-ovulation patients were analyzed. All patients were treated with oraling clomiphene （CC） 50 mg × 5 d or letrozole （LE） 2.5 mg × 5 d on 3-Sth day of menstrual cycles, and were administered hMG on menstruation 8-10th day till hCG injection day. The patients with ≤ 2 dominant follicles integrated to group A （n=186）, the patients with ≥ 3 dominant follicles integrated to group B （n=147）. Group A were intermuscular injected hCG l0 000 U, group B were intermuscular injected alarelin 0.15-0.45 mg. Both groups were for luteal support. Results： The mild （8.1% vs 2.7%） and moderate OHSS rates （3.2% vs 1.4%） as well as the ovulation rate （88.7% vs 95.2%） and the clinical pregnancy rate （21.0% vs 34.8%） between the two groups had the statistically significant differences, the difference of the abortion rate （15.4% vs 18.8%） did not have the significance. Conclusion： The use of alarelin instead of hCG is able to successfully induce ovulation and causes the ovulation rate as well as the clinical pregnancy rate clearly enhance.