醋酸环丙孕酮联合来曲唑治疗多囊卵巢综合征伴不孕症患者的疗效分析

The curative effect analysis of cyproterone acetate combined with letrozole in the treatment of patients with polycystic ovary syndrome and infertility

目的 探讨醋酸环丙孕酮联合来曲唑治疗多囊卵巢综合征（PCOS）导致排卵障碍不孕患者的临床效果.方法 选择124例PCOS并不孕患者,分为3组.第1组为来曲唑组42例：醋酸环丙孕酮联合来曲唑治疗PCOS；第2组单纯对照组40例：单纯口服醋酸环丙孕酮治疗PCOS;第3组氯米芬组42例：口服醋酸环丙孕酮联合氯米芬治疗PCOS.分别记录3组患者性激素水平、周期排卵率、妊娠率.结果 患者的T、LH、LH/FSH均有显著降低（P＜0.01）,42个促排卵周期中35个周期有优势卵泡（87.5％）,34个周期有排卵（85.0％）,7例妊娠（17.5％）.来曲唑组与单纯对照组比较,性激素、周期排卵率、妊娠率有统计学意义（P＜0.05）.氯米芬组排卵期、黄体期的E2和排卵期的LH高于来曲唑组,比较无明显统计学意义（P＞0.05）.结论 口服醋酸环丙孕酮联合来曲唑治疗多囊卵巢综合征导致排卵障碍不孕患者有较好疗效,可以获得与氯米芬同样的效果,为PCOS导致排卵障碍不孕患者增加了一种选择.

Objective To explore the clinical effect of cyproterone acetate combined with letrozole in the treatment of patients with ovulation disorder infertility caused by polycystic ovary syndrome （PCOS）.Methods 124 patients with PCOS and infertility were selected and divided into three groups.Letrozole Group （42 cases） received cyproterone acetate combined with letrozole; Control Group （40 cases） received oral cyproterone acetate treatment; Clomiphene Group （42 cases） received oral cyproterone acetate combined with clomiphene.Record the sex hormone levels,cycle ovulation rate and pregnancy rate in three groups.Results The levels of T,LH,LH/FSH significantly reduced （P ＜ 0.01）.In 42 ovulation induction cycles,35 cycles （87.5％） had advantaged follicle,34 cycles （85.0％） had ovulation,with 7 cases of pregnancy （17.5％）.There were statistically significant differences in sex hormone levels,cycle ovulation rate,pregnancy rate between Letrozole Group and Control Group （P ＞ 0.05）.E2 levels in ovulation phase and luteal phase and LH level in ovulation phase of Clomiphene Group were higher than those of Letrozole Group,without statistically significant differences （P ＞ 0.05）.Conclusions Cyproterone acetate combined with letrozole in the treatment of patients with ovulation disorder infertility caused by polycystic ovary syndrome has good curative effect,can obtain same effect as clomiphene,offer one more choice for patients with ovulation disorder infertility caused by polycystic ovary syndrome.