地屈孕酮片辅助治疗PCOS合并不孕的效果及对氧化指标影响

Effet of dydrogesterone tablets for adjuvant therapy of infertility patients with polycystic ovary syndrome and its influence on the oxidation indexes

目的:探讨地屈孕酮片辅助治疗PCOS合并不孕对患者卵巢储备功能、性激素及氧化指标的随机数表法分为对观察组、对照组各56例,两组均给予二甲双胍治疗,观察组联合地屈孕酮片治疗,疗程6个月。比较治疗前后两组月经情况、子宫内膜厚度、卵巢储备功能、性激素指标[卵泡雌激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))]、反应性氧化物(ROS)、总氧化态(TAS)、氧化应激指数(OSI)变化,记录排卵率、妊娠率、不良反应。结果:治疗后观察组月经期短于对照组,月经量、卵巢体积、卵泡数量低于对照组,子宫内膜厚度(9.4±1.0 mm)高于对照组(7.9±0.8 mm),血清FSH(3.18±0.65 U/L)、LH(7.54±1.55 U/L)、OSI(16.80±1.13)、ROS(14.10±1.24 mmol H_(2)O_(2)equiv/L)水平均低于对照组(4.23±0.72U/L、10.50±2.61U/L、18.24±1.18、16.62±1.37 mmol H_(2)O_(2)equiv/L),E_(2)(74.18±7.73 pg/ml)高于对照组(66.94±7.40 pg/ml)(均P<0.05);随访1年,观察组排卵率(83.9%)、妊娠率(58.9%)均高于对照组(66.1%、37.5%)(均P<0.05);两组不良反应发生率(5.4%、8.9%)无差异(P=0.463)。结论:地屈孕酮片辅助二甲双胍治疗PCOS合并不孕,能明显改善患者卵巢储备功能和性激素水平,降低血清氧化指标水平,提高排卵率和妊娠率。

Objective:To investigate the effects of dydrogesterone tablets for adjuvant therapy of infertility patients with and polycystic ovary syndrome(PCOS)on their ovarian reserve function,sex hormones levels,and oxidation indexes.Methods:A total of 112 cases of infertility patients with PCOS were selected as the research objects from February 2020 to February 2022.According to random number table method,these patients were divided into control group and observation group,with 56 cases in each group.The patients in the control group were treated with metformin for 6 months,and the patients in the observation group were treated with dydrogesterone tablets combined with metformin for 6 months.The menstrual conditions,the endometrial thickness,the ovarian reserve function,the levels of sex hormone indexes,such as follicular estrogen(FSH),luteinizing hormone(LH),and estradiol(E_(2)),and the changes of the reactive oxides(ROS),total oxidation state(TAS),and oxidative stress index(OSD)of the patients before and after treatment were compared between the two groups.The ovulation rate,the pregnancy rate,and the adverse reactions of the patients in the two groups were recorded.Results:After treatment,the menstrual period of the patients in the observation group was significantly shorter than that of the patients in the control group.The menstrual volume,the ovarian volume,and the number of follicles of the patients in the observation group were significantly lower than those of the patients in the control group.The endometrial thickness(9.4±1.0 mm)of the patients in the observation group was significantly higher than that(7.9±0.8 mm)of the patients in the control group.The levels of serum FSH(3.18±0.65 U/L),LH(7.54±1.55 U/L),OSI(16.80±1.13),ROS(14.10±1.24 mmol H_(2)O_(2) equiv/L)of the patients in the observation group were significantly lower than those(4.23±0.72 U/L,10.50±2.61 U/L,18.24±1.18,and 16.62±1.37 mmol H_(2)O_(2) equiv/L)of the patients in the control group.The E_(2) level(74.18±7.73 pg/ml)of the patients in the observation group was significantly higher than that(66.94±7.40 pg/ml)of the patients in the control group(all P<0.05).After 1 year of follow-up,the ovulation rate(83.9%)and the pregnancy rate(58.9%)of the patients in the observation group were significantly higher than those(66.1% and 37.5%)of the patients in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions(5.4%vs.8.9%)of the patients between the two groups(P=0.463).Conclusion:Dydrogesterone tablets combined with metformin for treating the infertility patients with PCOS can significantly improve their ovarian reserve function and sex hormone levels,reduce the expression of the serum oxidation indexes,and increase the ovulation and pregnancy rates.