炔雌醇环丙孕酮联合人绝经期促性腺激素、克罗米芬治疗多囊卵巢综合征不孕患者的效果观察

Effects of ethinylestradiol combined with human menopausal gonadotropin and clomiphene on infertility patients with polycystic ovary syndrome

目的:探究炔雌醇环丙孕酮联合人绝经期促性腺激素、克罗米芬治疗多囊卵巢综合征(PCOS)不孕患者的效果。方法:选取116例多囊卵巢综合征不孕患者,按照治疗方案不同分为联合组和参照组,每组各58例。参照组采用克罗米芬+人绝经期促性腺激素治疗,联合组采用炔雌醇环丙孕酮+人绝经期促性腺激素+克罗米芬治疗。观察两组总有效率、治疗前后血清激素指标[促卵泡激素(FSH)、雌二醇(E_(2))、促黄体生成素(LH)、睾酮(T)]、治疗前后血清相关因子[结缔组织生长因子(CTGF)、血管生成素样蛋白(Angpt12)、肾上腺源性雄激素(DHEAS)]、排卵率、治疗90 d后妊娠率。结果:联合组总有效率93.10%高于参照组79.31%(P<0.05);治疗后,联合组FSH、E_(2)、LH、T、CTGF、DHEAS、Angpt12低于参照组(P<0.05);治疗90 d后联合组妊娠率70.69%高于参照组51.72%(P<0.05)。结论:炔雌醇环丙孕酮联合人绝经期促性腺激素、克罗米芬治疗PCOS不孕患者效果显著,能改善血清激素水平,提高排卵率及妊娠率。

Objective:To investigate the effects of ethinylestradiol combined with human menopausal gonadotropin(HMG)and clomiphene on infertility patients with polycystic ovary syndrome(PCOS).Methods:116 cases of PCOS infertility patients were randomized into the combined therapy group and control group according to different therapy regimens,each with 58 cases.The control group adopted the treatment with clomiphene plus HMG,while the combined therapy group were treated with ethinylestradiol combined with HMG and clomiphene.The serum hormone indexes[follicle-stimulating hormone(FSH),estradiol(E_(2)),luteinizing hormone(LH),and testosterone(T)],serum related factors before and after treatment[connective tissue growth factor(CTGF),angiopoietin-like protein 2(Angptl2)and dehydroepiandrosterone sulfate(DHEAS)],ovulation rate and pregnancy rate 90 days after treatment were compared between the two groups.Results:The total effective rate in combined therapy group was 93.10%,which was higher than 79.31%in control group(P<0.05);after treatment,FSH,E_(2),LH,T,CTGF,DHEAS and Angptl2 in the combined therapy group was lower than those in the control group(P<0.05);and after 90 days of treatment,the pregnancy rate of combined therapy group was 70.69%,higher than 51.72%of the control group(P<0.05).Conclusion:Eynestradiol cyproterone combined with HMG and clomiphene has a significant effect on the treatment of PCOS infertility patients,which can improve the serum hormone level,and increase the ovulation rate and pregnancy rate.