不同剂量来曲唑对116例多囊卵巢综合征患者的SHBG与性激素水平的影响

Effects of different doses of letrozole on SHBG and sex hormone in the treatment of 116 cases of patients with polycystic ovary syndrome

目的：比较不同剂量来曲唑对多囊卵巢综合征（PCOS）患者SHBG与性激素水平的影响,以便优化来曲唑治疗方案。方法 ：选取116例PCOS不孕患者,按随机数字表法分为A组62例和B组54例。2组患者均于月经周期或黄体酮撤药性出血第3~5天分别口服5.0 mg/d和7.5 mg/d来曲唑,连续应用5 d。监测每组患者卵泡发育,并于人绒毛膜促性腺激素（hCG）注射日采集外周静脉血,检测黄体生成素（LH）、雌二醇（E_2）、睾酮（T）、性激素结合球蛋白（SHBG）含量。结果 ：B组LH、E_2、SHBG水平明显高于A组,T水平明显低于A组（P〈0.05）;B组患者成熟卵泡数明显多于A组（P〈0.05）,而成熟卵泡平均径线、子宫内膜厚度比较,差异无统计学意义（P〉0.05）;B组患者妊娠比例明显高于A组（P〈0.05）,而排卵比例比较无显著性差异（P〉0.05）。结论 ：来曲唑治疗PCOS患者的助孕效果确切,可促进SHBG与性激素的分泌,以7.5 mg/d来曲唑治疗效果更优。

Objective： To discuss the influence of different doses of letrozole on sex horrnone binding globulin （SHBG） and sex hormone in the treatment of polycystic ovary syndrome （PCOS） so as to optimize the therapy regimen of letrozole. Methods： One hundred and sixteen cases of patients with PCOS were selected and randomly divided into group A （n=62） and group B （n=54）. Group A and B were orally given 5.0 mg/d and 7.5 mg/d ofletrozole for five days during menstrual cycle or from the third day to the fifth day of progesterone withdrawal bleeding herbs. The follicular development situations in the two groups were monitored, and the levels of luteinizing hormone （LH）, estradiol （E2）, testosterone （T） and SHBG were detected on the day of intramuscular injection of hCG. Results： The levels of LH, E2 and SHBG were significantly higher in group B than group A, and T level was significantly lower in group B than group A （P〈0.05）. The number of mature follicles was significantly greater in group B than group A （P〈0.05） and the pregnancy rate of group B was significantly higher than that of group A （P〈0.05）, however, there were no statistically significant differences between the two groups in mature follicle diameter, endometrial thickness and ovulation rate （P〉0.05）. Conclusion： The effect of letrozole on the assisted reproduction in the treatment of PCOS is exact, it can promote the secretion of SHBG and sex hormones, and the dose of 7.5 mg/d letrozole has better efficacy.