中国南北方多囊卵巢综合征不孕患者临床基线特征分布与疗效分析

Clinical baseline characteristics and efficacy analysis of infertile patients with polycystic ovary syndrome in different regions of south and north China

目的:分析我国南北方多囊卵巢综合征(PCOS)不孕患者临床基线特征及疗效的差异,从而为不同地域女性预防与治疗PCOS提供指导。方法:以秦岭-淮河线将644例PCOS患者按就诊医院分为北方和南方,随机给予小檗碱、来曲唑或小檗碱联合来曲唑治疗,配合超声监测排卵,疗程共6个月。观察南北方PCOS受试者临床基线特征及疗效的差异。结果:南方P C O S受试者年龄,身高,体质量,腰围,臀围,身体质量指数,左、右卵巢体积,孕酮,促黄体生成素/促卵泡生成素,游离睾酮指数,胰岛素浓度等显著低于北方PCOS受试者(P<0.01);左、右侧窦卵泡数,促卵泡生成素,性激素结合球蛋白水平,抗苗勒管激素显著高于北方PCOS受试者(P<0.05,P<0.01);南北方PCOS受试者的排卵率、受孕率、妊娠率、流产率及活产率差异均无统计学意义。结论:北方受试者的PCOS病情重于南方受试者,地域差异及病情严重程度对促排卵药物疗效及生殖结局没有明显影响。

Objective:To analyze the difference of clinical baseline characteristics and therapeutic effect of infertile patients with polycystic ovary syndrome(PCOS)in China,so as to provide guidance for the prevention and treatment of PCOS in women in different regions.Methods:A total of 644 PCOS according to the hospital patients were divided into northern and southern areas by Qinling Ling-Huaihe River line.They were randomly treated with berberine,letrozole or berberine combined with letrozole,combined with ultrasound to detect ovulation,and treated for a total of 6 months.The clinical baseline characteristics and therapeutic effects of PCOS subjects in northern and southern areas were observed.Results:Southern PCOS subjects were significantly lower in age,height,body mass,waist circumference,hip circumference,body mass index,left and right ovarian volume,progesterone,luteinizing hormone/follicle-stimulating hormone ratio,free testosterone index and insulin concentration than northern subjects(P<0.01);The levels of left and right follicle number,follicle-stimulating hormone,sex hormone binding globulin and anti-Müllerian hormone were significantly higher than those of northern PCOS subjects(P<0.05,P<0.01);However,under the same drug dose and cycle treatment,the ovulation rate,conception rate,pregnancy rate,abortion rate and live birth rate of PCOS subjects in the south and the north were not statistically significant.Conclusion:The disease of PCOS in northern subjects is more serious than that in southern subjects.Regional differences and the severity of the disease had no significant effect on the efficacy of ovulation stimulating drugs and reproductive outcomes.