人绝经期促性腺素联合曲普瑞林治疗多囊卵巢综合征患者排卵障碍的效果及对激素水平的影响

Effect of human menopausal gonadotropin combined with triamcinolone on ovulation dysfunction in polycystic ovary syndrome women and its influence on hormone levels

目的观察人绝经期促性腺素联合曲普瑞林治疗多囊卵巢综合征(PCOS)患者排卵障碍的临床疗效,并探讨其对患者激素水平的影响。方法以2016年1~11月期间上海中冶医院妇产科收治的69例PCOS患者作为研究对象,按数表法随机分为对照组34例和观察组35例。其中对照组采用人绝经期促性腺激素治疗,观察组则采用人绝经期促性腺激素联合曲普瑞林治疗,疗程4周。治疗结束后,比较两组患者的血清激素水平、妊娠情况及临床疗效。结果两组患者治疗前的血清雌二醇(E2)、黄体生成素(LH)、卵泡生成素(FSH)水平比较差异均无统计学意义(P>0.05);治疗后对照组患者的E2、LH及FSH水平分别为(85.72±26.54)pg/mL、(4.16±1.40)mU/L和(8.86±2.75)mU/L,明显低于观察组的(163.51±62.47)pg/mL、(6.49±1.34)mU/L和(11.65±2.54)mU/L,差异均有统计学意义(P<0.05);治疗后两组患者的在多胎率、流产率方面比较差异均无统计学意义(P>0.05),但观察组和对照组患者在内膜厚度[(12.85±1.21)mm vs(8.02±1.52)mm]、妊娠率(71.43%vs 47.06%)及OHSS发生率(5.71%vs 26.47%)方面比较,观察组均优于对照组,差异均具有统计学意义(P<0.05);观察组患者的治疗有效率为91.40%,明显高于对照组的67.65%,差异具有统计学意义(P<0.05)。结论人绝经期促性腺素联合曲谱瑞林治疗PCOS患者具有较好的疗效,其能有效改善患者体内激素水平,缓解排卵障碍,促进卵泡发育,最终提高妊娠率,在临床上具有一定的使用价值。

Objective To investigate and analyze the clinical efficacy of human menopausal gonadotropin（h MG） and combined therapy of estrogen in the treatment of ovulation dysfunction in polycystic ovary syndrome（PCOS） patients and the influence on hormone levels.Methods From January 2016 to November 2016,69 infertility patients in our hospital were selected and divided into the control group（n=34） and the study group（n=35） according to random number table method.The control group was treated with h MG for four weeks,while the study group was treated with h MG combined with triamcinolone for four weeks.After treatment,the serum hormone levels,pregnancy and clinical efficacy of the two groups were compared and analyzed.Results Before the treatment,there was no significant difference between the two groups in serum estradiol（E2）,luteinizing hormone（LH） and follicle stimulating hormone（FSH）（P〈0.05）.After the treatment,E2,LH and FSH in the control group were（85.72±26.54） pg/mL,（4.16±1.40） mU/L,（8.86±2.75） mU/L,respectively,which were significantly lower than corresponding（163.51±62.47） pg/mL,（6.49±1.34） mU/L and（11.65±2.54） mU/L in the study group（P〈0.05）; there was no significant difference in multiple pregnancy rate and abortion rate（P〈0.05）,but the endometrial thickness,the pregnancy rate and the incidence rate of OHSS in the study group were respectively（12.85±1.21） mm,71.43% and 5.71%,which were significantly better than（8.02±1.52） mm,47.06% and 26.47%（P〈0.05）; the effective rate was 67.65% in the control group versus 91.40% in the study group（P〈0.05）.Conclusion h MG combined triamcinolone has good curative effect in the treatment of PCOS patients,which can effectively improve the patient＇s hormone levels,alleviate anovulation,promote follicular development,and ultimately improve the pregnancy rate.It has a certain value in clinical practice,and is worthy of promotion.