不同剂量来曲唑联合二甲双胍治疗多囊卵巢综合征不孕患者的临床观察

Clinical observation of different letrozole doses and metformin in patients with polycystic ovary syndrome and infertility

目的 观察不同剂量来曲唑联合二甲双胍对多囊卵巢综合征(PCOS)不孕患者性激素水平及排卵、妊娠的影响。方法 120例PCOS不孕患者随机分为A、B、C、D组,在口服二甲双胍基础上分别在月经第5~9天加用来曲唑2.5、5、7.5 mg/d口服或在月经第5天顿服来曲唑20 mg,所有患者均完成3个月经周期治疗。比较4组性激素水平、排卵、妊娠及不良反应。结果 B组黄体生成素、雌二醇、睾酮水平最低,D组最高(P<0.01或0.05);A、B、C组排卵率和妊娠率均高于D组,B组更显著(P<0.05)。4组患者不良反应差异无统计学意义(P>0.05)。结论 5 mg/d来曲唑联合二甲双胍治疗PCOS不孕患者有助于改善性激素水平,提高排卵率和妊娠率。

Objective To observe the effects of different letrozole doses and metformin on sex hormone, ovulation and pregnancy in infertility patients with polycystic ovary syndrome(PCOS). Methods A total of 120 infertile patients with PCOS were randomly treated with metformin plus 2.5 mg/d(group A), 5 mg/d(group B), 7.5 mg/d(group C) oral letrozole between 5th and 9th menstrual day or 20 mg letrozole on 5th menstrual day(group D) for 3 menstrual cycles. Sex hormones,ovulation and pregnancy were compared among 4 groups. Results Luteinizing hormone, estradiol and testosterone levels were the lowest in group B and highest in group D(P<0.01 or 0.05). The ovulation and pregnancy rates were higher in groups A-C than in group D, especially in group B(P<0.05). The adverse reactions were comparable among 4 groups(P>0.05).Conclusion Combined 5 mg/d letrozole and metformin can improve sex hormones, ovulation and pregnancy in infertility patients with PCOS.