杨婷 王婕 杨蕾

[摘要] 目的 探討来曲唑联合枸橼酸氯米芬胶囊治疗多囊卵巢综合征（PCOS）患者的效果。 方法 选择2013年1月1日～2017年8月30日在宝鸡市妇幼保健院就诊并行促排卵治疗的90例PCOS患者为研究对象，根据治疗方式的不同将所有患者分为对照组、观察1组和观察2组，每组各30例。对照组患者予枸橼酸氯米芬胶囊50 mg，po，qd；观察1组患者在对照组治疗的基础上予来曲唑2.5 mg/dg，po，qd；观察2组患者在对照组治疗的基础上予来曲唑5.0 mg/d，po，qd，三组患者均连续用药5 d。于月经周期第10天开始，应用阴道超声监测卵泡发育和子宫内膜情况，记录人绒毛膜促性腺激素（HCG）注射日子宫内膜厚度、成熟卵泡数；统计各组的排卵率及妊娠率；采用化学发光法测定三组患者的黄体生成素（LH）、雌二醇（E2）、睾酮（T）、卵泡刺激素（FSH）水平。 结果 观察1组及观察2组HCG日子宫内膜厚度明显高于对照组，成熟卵泡数多于对照组，排卵率及妊娠率高于对照组，差异有统计学意义（P < 0.05）；同时，观察2组的排卵率及妊娠率均高于观察1组，差异有统计学意义（P < 0.05）。HCG注射日观察1组和观察2组的LH及T水平均高于对照组，E2水平均低于对照组，差异有统计学意义（P < 0.05）；观察2组FSH水平低于对照组，且E2水平低于观察1组，差异有统计学意义（P < 0.05）。 结论 来曲唑联合枸橼酸氯米芬胶囊治疗可增加PCOS患者子宫内膜厚度，提高排卵率及妊娠率，且5.0 mg/d来曲唑联合枸橼酸氯米芬胶囊效果更为明显。

[关键词] 多囊卵巢综合征；来曲唑；枸橼酸氯米芬胶囊

[中图分类号] R711.6 [文献标识码] A [文章编号] 1673-7210（2018）05（b）-0067-04

Curative effect analysis of Letrozole combined with Clomifene Citrate Capsules in the treatment of patients with polycystic ovary syndrome

YANG Ting WANG Jie YANG Lei

Department of Gynecology， Baoji Fuyou Health Hospital， Shaanxi Province， Baoji 721000， China

[Abstract] Objective To explore the effect of Letrozole combined with Clomiphene Citrate Capsules on patients with polycystic ovary syndrome. Methods Ninety PCOS patients with the treatment of ovulation in Baoji Fuyou Health Hospital from January 1st， 2013 to August 30th， 2017 were selected， patients were divided into three groups according to the different methods of treatment， 30 case in each groups. The control group was treated by Clomifene Citrate Capsules 50 mg/d， po， qd. The observation group 1 was treated by Letrozole 2.5 mg/d， po， qd， on the basis of the treatment of control group， while the observation group 2 was treated with Letrozole 5.0 mg/d， po， qd， all patients were treated for 5 days. On the 10th day of the menstrual cycle， the vaginal ultrasound was used to monitor follicular development and endometrial conditions， the thickness of uterine membrane， the number of mature follicle and the thickness of endometrium were recorded， the ovulation rate and pregnancy rate of each group were caculated. Levels of the LH， E2， T， FSH of the three groups were detected by chemiluminescent immunoassay. Results The thickness of uterine membrane of observing group 1 and observing group 2 was higher than that of control group at HCG day， the number of mature follicle and palace film thickness of the observation group 1 and 2 were obviously higher than those of the control group， the ovulation rate and pregnancy rate of observation group 1 and 2 was higher than the control group， the differences were statistically significant （P < 0.05）. The ovulation rate and pregnancy rate of observation group 2 was higher than the observation group 1， the difference was statistically significant （P < 0.05）. On HCG injection day， levels of LH and T in the observation group 1 and 2 were higher than that of the control group， level of E2 was lower than that of the control group， the differences were statistically significant （P < 0.05）. The level of FSH in the observation group 2 was lower than that in the control group， and the level of E2 was lower than that of observation group 1， the differences were statistically significant （P < 0.05）. Conclusion Letrozole combined with Clomifene Citrate Capsules can increase the thickness of uterine membrane of patients with polycystic ovary syndrome， improve the ovulation rate and pregnancy rate， and the effect of 5.0 mg/d Lytrizole combined with Clomifene Citrate Capsules has more obvious effect.

[Key words] Polycystic ovary syndrome； Letrozole； Clomifene Citrate Capsules

多囊卵巢综合征（polycystic ovary syndrome，PCOS）是绝经前女性最常见的内分泌和生殖障碍，其特征是高雄激素、代谢综合征和炎症，发病率占育龄女性的5%～10%[1]，临床表现主要为月经周期不规律、不孕、多毛和/或痤疮等慢性无排卵和高雄激素血症，是导致女性不孕的主要因素之一。目前，PCOS的药物治疗已取代手术治疗作为一线治疗方法，治疗的目的主要与患者的生育要求相关。枸椽酸氯米芬胶囊是一线促排卵药，但其对致宫颈黏液的质量和子宫内膜形态有不良影响[2]。……