多囊卵巢综合征的生殖内分泌特征、卵巢形态学改变与克罗米酚疗效间的关系

Study on correlation among endocrinologic characteristics, ovarian morphologic changes and therapeutic effect of clomiphene citrate in women with polycystic ovarian syndrome

目的 探讨多囊卵巢综合征 (PCOS)妇女用克罗米酚 (CC)促排卵治疗无效的原因 ,以预测其疗效。方法 41例PCOS患者均计算BMI ,行F G毛发评分 ,服CC前后测血清生殖激素水平 ,B超了解卵巢形态并监测排卵。结果 与CC治疗有反应组相比 ,无反应组的F G毛发评分、基础A、fT增高 ,卵泡数增多 ,卵巢体积及髓质面积增大 ,卵泡晚期FSH、LH、E2 降低 (P均 <0 0 5) ;相关回归显示平均卵泡数与T、A ,平均髓质面积与A呈正相关。结论 多毛患者对CC治疗的反应性降低。H P O轴功能状态可影响CC疗效 ;一定的激素水平和卵巢超声表现提示CC抵抗 ;卵巢超声形态与T。

Objective It would aim at predicting the treatment effect of CC to investigate the reason of irresponsiveness of the women with PCOS to CC therapy. Methods The BMI and F G scores of hair distribution of 41 PCOS cases were obtained. The levels of reproductive hormone were tested and features of ovarian morphology were gathered and ovulation was monitored through transvaginal ultrasonography before and after CC was administered. Results Compared with the responders,F G scores of hair distribution,levels of A and fT, follicle numbers increased, volume and ovarian stroma area ovarianed, levels of FSH, LH and E 2 in the nonresponders decreased( P <0 05). It was suggested by correlation and regression analysis that there was positive correlation between mean follicular numbers and T and A levels, between mean ovarian stroma area and A level. Conclusion The patients of hirsute decreased the activity of treatment with CC. The function of the H P O axis could affect the therapeutic effects of CC. The certain hormone levels and ovarian sonography occurrence may predict CC resistance. There was positive correlation between ovarian sonography changes and serum T and A levels.