3种促排卵药物治疗多囊卵巢综合征性不孕症的临床疗效对比

Comparison of the clinical efficacy of three ovulation-promoting drugs in the treatment of infertility due to polycystic ovary syndrome

目的对3种促排卵药物(氯米芬、他莫昔芬及来曲唑)治疗多囊卵巢综合征性不孕症的临床疗效予以评价,为临床医师选择合理用药方案提供参考。方法将本院2016年2月至2017年10月间所接诊的180例多囊卵巢综合征性不孕症患者纳入本次研究,以随机数字表法将入选患者分为采用来曲唑治疗的A组、他莫昔芬治疗的B组和氯米芬治疗的C组,每组均为60例,以HCG当日子宫内膜厚度、血清E2、P、LH水平、成熟卵泡数以及1年内临床妊娠、早期流产、OHSS发生率等作为优劣评价之参考项目。结果A组患者HCG日子宫内膜厚度、宫颈黏液评分、子宫内膜厚度以及临床妊娠率均高于其他两组,血清E2水平及早期流产、OHSS发生率均低与其他两组,组间差异有统计学意义(P<0.05)。结论针对多囊卵巢综合征性不孕症患者在临床行促排卵治疗的过程中,来曲唑的临床应用效果比氯米芬与他莫昔芬好,其不仅可对患者的激素状态有所改善,而且在卵泡排放、发育以及提高临床妊娠率方面也有一定优势。

Objective To evaluate the clinical efficacy of three ovulation-promoting drugs(clomiphene,tamoxifen and letrozole)in the treatment of polycystic ovary syndrome(PCOS)infertility,and to provide reference for clinicians in choosing rational drug regimens.Methods 180 cases of infertility with polycystic ovary syndrome in our hospital from February 2016 to October 2017 were included in this study.The selected cases were divided into group A(treated with letrozole),group B(treated with tamoxifen),and group C(treated with clomiphene)by random number table.Each group had 60 cases.The endometrial thickness,serum E2,P and LH levels,the number of mature follicles and the incidence of clinical pregnancy,early abortion and OHSS in one year were used as the reference items for evaluating the quality of HCG.Results The endometrial thickness,cervical mucus score,endometrial thickness and clinical pregnancy rate of group A were higher than those of the other two groups.The serum E2 level and the incidence of early abortion and OHSS were lower than those of the other two groups.The differences between the two groups were all with statistical significance(P<0.05).Conclusion The clinical effect of letrozole is better than clomiphene and tamoxifen in the treatment of polycystic ovary syndrome infertility.It can not only improve the hormone status of patients,but also have certain advantages in follicular discharge,development and clinical pregnancy rate.