联合用药对PCOS伴不孕患者血LH水平及受孕率的作用分析

Effects of combined medication on blood LH levels and pregnancy rate in patients with PCOS complicated by infertility

目的分析炔雌醇环丙孕酮片与二甲双胍缓释片联合克罗米芬治疗多囊卵巢综合征(PCOS)伴不孕对患者血促黄体生成激素(LH)水平、安全性及受孕率的影响。方法选取2015年1月至2016年8月接受治疗PCOS伴不孕患者94例,根据治疗方法不同分为对照组和观察组,每组47例。对照组患者给予炔雌醇环丙孕酮片联合克罗米芬治疗,观察组患者在对照组基础上加用二甲双胍治疗。观察并比较2组患者性激素水平、糖代谢指标、安全性指标、排卵率、先兆流产率及妊娠率。结果 2组患者治疗前LH、T、FSH、E2及LH/FSH水平比较差异无统计学意义(P>0.05)。2组患者治疗后LH、T、FSH、E2及LH/FSH水平均较治疗前下降,观察组患者治疗后T和LH/FSH水平低于对照组患者(P<0.05)。2组患者治疗前FPG、FIN及HOMA-IR水平比较差异无统计学意义(P>0.05)。2组患者治疗后FPG、FIN及HOMA-IR水平均较治疗前下降,观察组患者治疗后FPG、FIN及HOMA-IR水平低于对照组患者(P<0.05)。2组患者治疗前后AST、CRE及UREA水平比较差异无统计学意义(P>0.05)。观察组患者排卵率和妊娠率分别为82.98%,63.83%,对照组患者排卵率和妊娠率分别为61.70%,34.04%,2组患者排卵率和妊娠率比较差异有统计学意义(P<0.05)。2组患者先兆流产率比较差异无统计学意义(P>0.05)。结论炔雌醇环丙孕酮片与二甲双胍缓释片联合克罗米芬治疗多囊卵巢综合征疗效显著,安全性高,能有效提高排卵率和妊娠率,优于炔雌醇环丙孕酮片和克罗米芬联用。

Objective To investigate the effects of combined medication of ethinylestradiol and cyproterone acetate tablets as well as metformin sustained release tablets on blood luteinizing hormone（LH） levels and pregnancy rate in patients with polycystic ovary syndrome（PCOS） complicated by infertility. Methods A total of 94 patients with PCOS complicated by infertility who were admitted and treated in our hospital from January 2015 to August 2016 were enrolled in the study.According to different treatment methods,these patients were divided into control group（n = 47） and observation group（n =47）. The patients in control group were treated by ethinylestradiol and cyproterone acetate tablets combined with clomiphene,however,the patients in observation group,on the basis of control group,were treated by metformin. The levels of sex hormones,glucose metabolism,safety index,ovulation rate,threatened abortion rate and pregnancy rate were observed and compared between the two groups. Results Before treatment there were no significant differences in the levels of LH,T,FSH,E2 and LH/FSH between the two groups（P〉 0. 05）. After treatment the levels of LH,T,FSH,E2 and LH/FSH were decreased in both groups,moreover,the levels of T and LH/FSH in observation group were significantly lower than those in control group（P〈 0. 05）. Before treatment there were no significant differences in the levels of FPG,FIN and HOMA-IR between the two groups（P〉 0. 05）. After treatment,the levels of FPG,FIN and HOMA-IR were decreased in both groups,moreover,the levels of FPG,FIN and HOMA-IR in observation group were significantly lower than those in control group（P〈 0. 05）. However there were no significant differences in the levels of AST,CRE and UREA between the two groups before and after treatment（P〉 0. 05）. The ovulation rate and pregnancy rate in observation group were 82. 98% and 63. 83%,respectively,which in control group were 61. 70% and 34. 04%,respectively,there were significant differences between the two groups（P〈 0. 05）,but there was no significant difference in threatened abortion rate between the two groups（P〉 0. 05）. Conclusion The ethinylestradiol and cyproterone acetate tablets and metformin combined with clomiphene in treatment of polycystic ovary syndrome has significant curative effects,with good safety,which can effectively improve the ovulation rate and pregnancy rate,and thetherapeutic effects are superior to those of ethinylestradiol and cyproterone acetate tablets combined with clomiphene.