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目的:探讨丙氨瑞林代替hCG诱导排卵预防卵巢过度刺激综合征(OHSS)的临床应用。方法:分析WHOⅡ型无排卵患者333个超促排卵周期,患者均于月经周期第3~5日开始口服克罗米芬(CC)50 mg,qd×5 d;或来曲唑(LE)2.5 mg,qd×5 d,月经第8~10日开始肌肉注射hMG至hCG注射日。阴道B超下显示≤2个优势卵泡者纳入A组,肌肉注射hCG 10 000 U;≥3个优势卵泡者纳入B组,当日肌肉注射丙氨瑞林0.15~0.45 mg;排卵后均给予黄体支持并指导同房。结果:A组186个周期,B组147个周期,A、B组间轻度OHSS发生率(8.1%vs 2.7%)、中度OHSS发生率(3.2%vs 1.4%)以及排卵率(88.7%vs 95.2%)、临床妊娠率(21.0%vs 34.8%)均有显著性差异(P<0.05),但流产率(15.4%vs 18.8%)差异无统计学意义(P>0.05)。结论:丙氨瑞林代替hCG诱发排卵可有效降低OHSS发生率,并使排卵率以及临床妊娠率明显提高。
Objective: To investigate the clinical application of ararelin in place of hCG inducing ovulation to prevent ovarian hyperstimulation syndrome (OHSS). Methods: The data of 333 ovarian hyperstimulation cycles in WHO type Ⅱ patients without ovulation were analyzed. All patients were started oral clomiphene citrate (CC) 50 mg, qd × 5 d or letrozole (LE) 2.5 mg on the 3rd to 5th menstrual cycle, qd × 5d, MCH 8 to 10 began intramuscular injection of hMG to hCG injection day. Vaginal B ultrasound ≤ 2 dominant follicles were included in group A, intramuscular injection of hCG 10,000 U; ≥ 3 dominant follicles were included in the group B, the day of intramuscular injection of Alarelin 0.15 ~ 0.45 mg; were given luteal support after ovulation And guide the same room. Results: There were 186 cycles in group A and 147 in group B. The incidence of mild OHSS (8.1% vs 2.7%), moderate OHSS (3.2% vs 1.4%) and ovulation rate (88.7% vs 95.2%). The clinical pregnancy rate (21.0% vs 34.8%) was significantly different (P <0.05), but the miscarriage rate was no significant difference (15.4% vs 18.8%) (P> 0.05). Conclusion: Arimidex instead of hCG induced ovulation can effectively reduce the incidence of OHSS, and the ovulation rate and clinical pregnancy rate was significantly increased.