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目的将来曲唑(LE)与克罗米酚(CC)分别用于多囊卵巢综合征(PCOS)共80例,比较LE及CC对卵泡发育、子宫内膜、生殖激素及妊娠率的影响。方法选择PCOS 80例随机分成两组,各40例,均于月经来潮或撤退性出血第3-5天口服LE2.5 mg与CC50mg共5天,超声监测卵泡发育,当最大卵泡平均直径≥18mm时,肌肉注射绒毛膜促性腺激素(hCG)5000-1000 IU诱发排卵,于hCG日取肘静脉血测定黄体生成素(LH)、雌二醇(E2)、睾酮(T),并观察排卵率、子宫内膜厚度、生殖激素及妊娠率的变化。结果出现优势卵泡LE组30例,CC组17例(P<0.05);单卵泡发育LE组23例,CC组5例(P<0.05);HCG注射日子宫内膜厚度LE组(9.93±1.45)mm,CC组(5.83±0.86)mm(P<0.01);LE组在HCG日血清E2为(199.0±122.4)pg/m l,CC组为(762±287.8)pg/m l,差异有统计学意义(P<0.05)。血清T和LH水平,在两组间差异无统计学意义(P>0.05)。结论 LE促排卵效果好,单卵泡发生率高,降低卵巢过度刺激综合征、多胎妊娠的发生率。
Objective To evaluate the effect of letrozole (LE) and clomiphene citrate (CC) on polycystic ovary syndrome (PCOS) in 80 patients. The effects of LE and CC on follicular development, endometrium, reproductive hormones and pregnancy rates were compared. Methods Eighty PCOS patients were randomly divided into two groups (n = 40). All of them were given LE2.5 mg and CC50 mg orally for 3-5 days after menstruation or withdrawal bleeding for 5 days. The follicles were monitored by ultrasound. When the average diameter of the largest follicles was ≥18 mm , Intramuscular injection of chorionic gonadotropin (hCG) 5000-1000 IU induced ovulation, cubital vein on the hCG daily test for luteinizing hormone (LH), estradiol (E2), testosterone (T), and observe the ovulation rate , Endometrial thickness, reproductive hormones and pregnancy rate changes. The results showed that there were 30 cases of superior follicles in LE group and 17 cases in CC group (P <0.05). There were 23 cases of single follicular development in LE group and 5 cases in CC group (P <0.05). The endometrial thickness of LE group on HCG injection day was 9.93 ± 1.45 ) in the CC group and (5.83 ± 0.86) mm in the CC group (P <0.01). The serum level of E2 in the LE group was (199.0 ± 122.4) pg / ml on HCG day and (762 ± 287.8) pg / Significance (P <0.05). Serum T and LH levels, no significant difference between the two groups (P> 0.05). Conclusions LE has a good effect of promoting ovulation and ovulation, the incidence of single follicles is high, and the incidence of ovarian hyperstimulation syndrome and multiple pregnancy are decreased.