多囊卵巢综合征个体化调整内分泌治疗疗效观察

Efficacy of individualized adjustment of endocrine in patients with polycystic ovary syndrome

目的:探讨个体化调整内分泌策略治疗多囊卵巢综合征(PCOS)的临床疗效。方法:根据睾酮(T)、促黄体生成素(LH)水平将220例PCOS患者分为3组。A1组(基础状态血清T、LH水平同时升高)50例,给予炔雌醇环丙孕酮(达英-35)2个周期、去氧孕烯炔雌醇(妈富隆)1个周期口服;A2组(基础状态血清T水平升高)40例,给予达英-35 1个周期、屈螺酮炔雌醇(优思明)2个周期口服;A3组(基础状态血清LH水平升高)130例,行达英-35 1个周期、妈富隆2个周期口服;然后促排卵。结果:A1组调整内分泌后血清T、LH、FSH、LH/FSH较调整前下降(P<0.05),A2组调整后血清T、LH/FSH较调整前下降(P<0.05),A3组调整后血清T、LH、LH/FSH较调整前下降(P<0.05)。3组排卵率、有效率、不良反应发生率差异无统计学意义(P>0.05)。220例总体排卵率达60.0%,总体有效率达54.5%,总体不良反应发生率为5.5%。结论:个体化调整内分泌能明显改善PCOS患者体内内分泌紊乱状态,提高排卵率及临床妊娠率,安全性较高。

Aim： To explore the efficacy of individualized adjustment of endocrine in the treatment of polycystic ovary syndrome（ PCOS）. Methods： A total of 220 patients with PCOS were collected,and divided into A1,A2 and A3 groups according to the levels of testosterone（ T） and luteinizing hormone（ LH） before treatment. A1 group（ high level of T and LH,n = 50） was given Diane-35 for 2 cycles and Marvelon for 1 cycle,A2 group（ high level of T,n = 40） was given Diane-35 for 1 cycle and Yasmin for 2 cycles,and A3 group（ high level of LH,n = 130） was given Diane-35 for 1 cycle and Marvelon for 2 cycles. Then ovulation induction was performed. Results： After the adjustment,serum T,LH,FSH and LH/FSH in A1 group decreased（ P 0. 05）; serum T and LH/FSH in A2 group decreased（ P 0. 05）; serum T,LH and LH/FSH in A3 group decreased significantly（ P 0. 05）. The ovulation rate,effective rate,and the incidence of adverse reactions among the three groups had no statistical differences（ P 0. 05）. The total ovulation rate,effective rate,and the incidence of adverse reactions of the 220 cases were 60. 0%,54. 5% and 5. 5%. Conclusion： Individualized adjustment of endocrine can relieve endocrine disorder situation of patients with PCOS,and increase the ovulation rate and clinical pregnancy rate,with high safety.