Hp-HMG联合炔雌醇环丙孕酮治疗多囊卵巢综合征不孕的效果

Effect of Hp-HMG Combined with Ethinylestradiol and Cyproterone in the Treatment of Infertility with Polycystic Ovarian Syndrome

目的:探究高浓度尿促性素(Hp-HMG)联合炔雌醇环丙孕酮治疗对多囊卵巢综合征(PCOS)不孕患者卵巢功能及黄体生成素(LH)、睾酮(T)、黄体生成素/卵泡刺激素(LH/FSH)水平的影响。方法:选取我院妇产科2019年6月至2020年6月接受诊治的84例PCOS不孕症患者作为研究对象,按照随机数字表法将所有患者分为观察组(n=42)和对照组(n=42)。对照组患者给予炔雌醇环丙孕酮片口服治疗,观察组患者在此基础上予以Hp-HMG注射治疗。两组患者均以21 d为1个治疗周期,连续治疗3个周期。比较两组患者治疗后临床疗效,治疗前后性激素水平、卵巢功能,统计治疗期间不良反应,治疗后24个月随访观察两组患者排卵及妊娠情况。结果:观察组患者治疗总有效率为92.86%,高于对照组的76.19%(P<0.05)。治疗后,两组患者卵巢的体积均较治疗前减小,且观察组患者治疗后卵巢体积减小程度较对照组更为明显(P<0.05);两组患者直径10~14 mm卵泡数、直径≥15 mm卵泡数及最大卵泡直径均较治疗前增加,观察组患者增加程度较对照组更为明显(P<0.05)。治疗后,两组患者LH、T、LH/FSH水平均较治疗前降低,观察组患者LH、T、LH/FSH水平降低程度较对照组更为明显(P<0.05)。两组患者不良反应发生率差异无统计学意义(7.14%vs.11.90%,P=0.710)。随访期间,观察组患者排卵率及自然妊娠率分别为90.48%、59.52%,均高于对照组的71.43%、30.95%(P<0.05)。结论:Hp-HMG联合炔雌醇环丙孕酮可通过改善PCOS不孕症患者性激素水平,从而促进卵巢正常排卵,改善卵巢功能,提高患者自然受孕率,对PCOS不孕症治疗效果显著,且具有一定安全性。

Objective:To investigate the effects of highly-purified menotropin(Hp-HMG)combined with ethinylestradiol and cyproterone on ovarian function and the levels of luteinizing hormone(LH),testosterone(T),luteinizing hormone/follicle stimulating hormone(LH/FSH)in patients with polycystic ovarian syndrome(PCOS)infertility.Methods:84 patients with PCOS infertility who were diagnosed and treated in obstetrics and gynecology department of our hospital between June 2019 and June 2020 were randomly divided into the observation group(42 cases)and the control group(42 cases)according to the random number table method.The control group was treated with ethinylestradiol and cyproterone acetate tablets orally,and the observation group was treated with Hp-HMG injection on this basis.Both groups were treated for 3 consecutive cycles treatment with 21 d as one treatment cycle.The clinical efficacy after treatment,the level of sex hormone and ovarian status before and after treatment and 24 months follow-up after treatment were compared between the two groups.Adverse reactions during treatment were counted.Results:The total effective rate of the observation group was higher than that of the control group(92.86%vs 76.19%,P<0.05).After treatment,the volume of ovarie of patients in both groups was reduced,and the observation group was more obvious on the reduction degree of the volum of ovarie than the control group(P<0.05).The number of follicles with diameter of 10-14 mm,the number of follicles with diameter≥15 mm and the maximum diameter of follicles in both groups were increased compared with those before treatment,and those in the observation group were higher than the control group(P<0.05).After treatment,the levels of LH,T,LH/FSH in the two groups were lower than those before treatment,and the degree of rduction in the observation group were more obvious than the control group(P<0.05).During the follow-up,the ovulation rate and natural pregnancy rate in the observation group were 90.48%and 59.52%,which were higher than 71.43%and 30.95%in the control group(P<0.05).There was no statistical difference in the incidence in adverse reactions between the two groups(7.14%vs.11.90%,P=0.710).Conclusion:Hp-HMG combined with ethinylestradiol and cyclopropane can improve the level of sex hormones in patients with PCOS infertility,promote normal ovulation,improve the natural pregnancy rate of patients,which has significant effect in treating PCOS infertility,and it is safe.