雌激素在不明原因薄型子宫内膜治疗中的应用

Application of estrogen in treatment of unexplained thin endometrium

目的探讨雌激素在不明原因薄型子宫内膜治疗中的应用。方法选取2014年1月至2016年6月在我院生殖中心就诊的96例不明原因薄型子宫内膜患者,采用小剂量阿司匹林联合雌激素治疗,按照随机数字表法分为3组,给予不同的雌激素制剂和给药方式:补佳乐口服组、芬吗通口服组和芬吗通阴道用药组,每组32例。比较3组患者治疗前、后子宫内膜的厚度、类型、血流情况,血清雌二醇(E2)水平及临床妊娠率等。结果 3组患者经药物治疗后,子宫内膜的厚度、类型、血流情况均较治疗前有显著改善(P<0.05),血清E2水平、临床妊娠率亦显著高于治疗前(P<0.05);各组间治疗后情况比较,芬吗通阴道用药组的子宫内膜厚度[(9.02±0.23)mm]、血清E2水平[(1 853.5±255.8)pmol/L]及临床妊娠率(53.13%)均显著优于补佳乐口服组[分别为(7.80±0.95)mm、(1 201.4±198.4)pmol/L、25.00%]和芬吗通口服组[分别为(8.04±0.43)mm、(1 395.3±203.3)pmol/L、28.13%](P<0.05)。结论阿司匹林联合雌激素阴道给药用于治疗薄型子宫内膜可以获得较满意的效果,但尚需大样本的前瞻性研究探讨验证。

Objective：To investigate the application of estrogen in unexplained thin endometrium.Methods： Ninety six patients with unexplained thin endometrium were treated with small dose of aspirin combined with estrogen in our hospital from Jan.2014 to Jun.2016.According to the random number table,the patients were divided into 3 groups and given different estrogen preparations：oral progynova grop,femonston oral grop,femonston vaginal administration group,32 patients in each group.The endometrial thickness,type,blood flow,blood estradiol（E2）concentration and pregnancy rate were compared before and after treatment among the three groups.Results： The endometrial thickness,type,and blood flow were significantly improved after drug treatment（P〈0.05）,and serum E2 levels and clinical pregnancy rate were also significantly higher than before treatment in the patients with unexplained thin endometrium（P〈0.05）.The endometrial thickness in femonston vaginal administration group[（9.02±0.23）mm],E2 levels[（1 853.5±255.8）pmol/L]and the pregnancy rate（53.13%）were significantly higher than those in oral progynova group[（7.80±0.95）mm,（1 201.4±198.4）pmol/L,25.00%,respectively]and femonston oral group [（8.04±0.43）mm,（1 395.3±203.3）pmol/L,28.13%,respectively]（P〈0.05）.Conclusions：Aspirin combined with estrogen treatment for the patients with unexplained thin endometrium can get satisfactory results.However,a large sample of prospective studies is still needed to verify.