枸橼酸氯米芬与来曲唑用于多囊卵巢综合征性不孕患者促排卵效果分析

Effect of Clomiphene Citrate and Letrozole on Ovulation Induction in Infertile Patients with Polycystic Ovary Syndrome

目的对比分析多囊卵巢综合征性不孕患者应用枸橼酸氯米芬(克罗米芬)与来曲唑治疗的促排卵效果。方法将该院2017年1月—2019年12月收治的196例多囊卵巢综合征性不孕患者分成两组,根据分组,组别为甲组与乙组,每组98例。应用克罗米芬治疗患者设为甲组,应用来曲唑治疗患者设为乙组,比较分析两组患者卵泡发育及子宫内膜状况、性激素水平、排卵与妊娠情况。结果甲组成熟卵泡个数、平均直径分别为(2.24±0.41)个、(25.89±3.81)mm,数值大于乙组(1.48±0.46)个、(20.32±3.75)mm,差异有统计学意义(t=12.210、10.310,P<0.05);子宫内膜厚度、宫颈黏液评分分别为(7.23±1.67)mm、(3.35±1.01)分,数值小于乙组(9.68±1.82)mm、(5.46±1.12)分,差异有统计学意义(t=9.820、13.850,P<0.05)。甲组雌二醇水平为(340.27±12.35)pg/mL,明显高于乙组(242.33±11.23)pg/mL,差异有统计学意义(t=58.080,P<0.05);两组卵泡刺激素、黄体生成素水平比较差异无统计学意义(P>0.05)。甲组排卵率、卵巢过度刺激综合征(OHSS)分别为82.65%、8.16%,乙组分别为66.33%、0.00%,比较差异有统计学意义(χ^2=6.873、6.386,P<0.05);两组妊娠率、多胎妊娠率对比差异无统计学意义(P>0.05)。结论在多囊卵巢综合征性不孕患者治疗中,克罗米芬促排卵效果优于来曲唑,而来曲唑有助于减少OHSS的发生,应根据临床实际情况合理用药。

Objective To compare and analyze the effect of clomiphene citrate(clomiphene citrate)and letrozole on ovulation promotion in patients with polycystic ovary syndrome infertility.Methods The 196 cases of infertility patients with polycystic ovary syndrome admitted in the hospital from January 2017 to December 2019 were divided into two groups.According to the grouping:group A and group B,with 98 cases in each group.The patients treated with clomiphene were set as group A,and the patients treated with letrozole were set as group B.The two groups were compared and analyzed for follicular development and endometrial status,sex hormone levels,ovulation and pregnancy.Results The number and average diameter of mature follicles in group A were(2.24±0.41)and(25.89±3.81)mm,respectively,which were larger than those in group B(1.48±0.46)and(20.32±3.75)mm,the difference was statistically significant(t=12.210,10.310,P<0.05);Endometrial thickness and cervical mucus score were(7.23±1.67)mm and(3.35±1.01)points,respectively,which were smaller than group B(9.68±1.82)mm and(5.46±1.12)points,the difference was statistically significant(t=9.820,13.850,P<0.05).The level of estradiol in group A was(340.27±12.35)pg/mL,which was significantly higher than that in group B(242.33±11.23)pg/mL,the difference was statistically significant(t=58.080,P<0.05);comparison of follicle stimulating hormone and luteinizing hormone levels between the two groups was not statistically significant difference(P>0.05).The ovulation rate and ovarian hyperstimulation syndrome(OHSS)in group A were 82.65%and 8.16%,respectively,and in group B were 66.33%and 0.00%,respectively.The difference was statistically significant(χ^2=6.873,6.386,P<0.05);There was no statistically significant difference in the rate of multiple pregnancy(P>0.05).Conclusion In the treatment of infertility patients with polycystic ovary syndrome,clomiphene is better than letrozole in promoting ovulation,and letrozole can help reduce the occurrence of OHSS,so it should be used rationally according to the actual clinical situation.