高纯度尿促性腺激素联合来曲唑治疗多囊卵巢综合征不孕患者的疗效观察

Effect of High-purity Urinary Gonadotropin Combined with Letrozole in the Treatment of Infertility Patients with Polycystic Ovary Syndrome

【目的】探讨高纯度尿促性腺激素(Hp-HMG)联合来曲唑治疗多囊卵巢综合征不孕患者的临床疗效。【方法】选取本院2016年1月至2020年10月在西安国际医学中心医院诊治的80例多囊卵巢综合征不孕患者,按照随机数表法分为观察组和对照组.每组40例。对照组采用Hp^HMG(75〜150 U/d)治疗7 d,观察组采用来曲唑2.5 mg/d连续3 d加Hp-HMG(75〜150 U/d)连续4 d治疗。比较两组患者治疗前后血脂水平、子宫内膜情况及治疗后卵泡发育、排卵情况、妊娠情况、不良反应发生情况。【结果】两组患者治疗前血脂水平比较差异均无统计学意义(均P>0.05);治疗后,观察组患者总胆固醇(TC)、三酰甘油(TG)显著低于对照组(均P<0.05),但两组患者高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较差异无统计学意义(均P>0.05)。两组患者治疗前后子宫内膜厚度、宫腔容积比较差异均无统计学意义(均P>0.05)。治疗后,观察组患者促成熟卵泡数、成熟卵泡平均直径、最大卵泡直径、10〜14 cm卵泡个数、〉14 cm卵泡个数均高于对照组,其差异均有统计学意义(均P<0.05)。观察组患者排卵例数、临床妊娠率均显著高于对照组,差异均有统计学意义(均P<0.05)。两组患者均未发生卵巢过度刺激综合征、未破裂卵泡黄素化综合征及血常规异常,仅对照组出现1例注射部位红肿。【结论】HpHMG联合来曲唑治疗多囊卵巢综合征不孕患者,可提高患者排卵率和妊娠率,改善血脂水平,且安全性高,值得临床推广应用。

【Objective】To investigate the effect of high-purity urinary tropulin(Hp-HMG)combined with letrozole in the treatment of infertility patients with polycystic ovary syndrome.【Methods】Eighty infertility patients with polycystic ovary syndrome who were treated in our hospital from January 2016 to October 2020 were enrolled.The patients were divided into Hp-HMG plus letrozole group and Hp-HMG group according to the touch ball method.Hp-HMG group received Hp-HMG 75-150 U/d treatment(for 7 consecutive days),Hp-HMG plus letrozole group received letrozole 2.5 mg/d(for 3 consecutive days)plus Hp-HMG 75-150 U/d(for 4 consecutive days).The blood lipid levels,uterus and follicular conditions,ovulation,pregnancy,and adverse reactions were observed.[Results]There was no significant difference in serum lipid levels between the two groups before treatment(P>0.05).After treatment,the levels of TC and TG in Hp-HMG plus letrozole group were significantly lower than those in the Hp-HMG group(P<0.05).There was no significant difference in LDL and HDL between the two groups(P>0.05).There were no significant differences in the thickness of endometrium and uterine volume between the two groups before and after treatment(P>0.05).After treatments the number of mature follicles,the average diameter of mature follicles,the maximum follicle diameter,the number of 10-14 cm follicles,and the number of>14 cm follicles in Hp-HMG plus letrozole group were higher than those in Hp-HMG group(P<0.05).The number of ovulation and the clinical pregnancy rate of Hp-HMG plus letrozole group were higher than those of Hp-HMG group,the difference was statistically significant(P<C0.05).There were no ovarian hyperstimulation syndrome,unruptured follicular luteinization syndrome and abnormal blood routine in both groups.One case of redness was found in the Hp-HMG group.[Conclusion]Hp-HMG combined with letrozole is safe in the treatment of polycystic ovary syndrome infertility,and can improve ovulation rate and pregnancy rate and improve blood lipid levels.