董灵丽

[摘要] 目的 探討克罗米芬联合二甲双胍治疗多囊卵巢综合征合并不孕患者的临床效果。 方法 回顾性选取2018年1月至2020年1月我院多囊卵巢综合征合并不孕患者100例，依据治疗方法分为二甲双胍联合克罗米芬治疗组（联合治疗组，n=50）和克罗米芬单独治疗组（单独治疗组，n=50），统计分析两组患者BMI、FPG、FINS、内膜厚度、性激素水平、促排卵时间、成熟卵泡个数、排卵、妊娠、早孕流产情况。 结果 联合治疗组治疗后较治疗前BMI、FPG、FINS降低幅度、内膜厚度增厚幅度均显著高于单独治疗组（P<0.05）。联合治疗组治疗后较治疗前LH、FSH、T、DHEAS、LH/FSH降低幅度、E2、SHBG水平升高幅度均显著高于单独治疗组（P<0.05）。联合治疗组患者成熟卵泡个数显著多于单独治疗组（P<0.05），但两组患者促排卵时间比较，差异无统计学意义（P>0.05）。联合治疗组患者妊娠率为50.00%（25/50），显著高于单独治疗组的20.00%（10/50）（P<0.05），早孕流产率为0，显著低于单独治疗组的8.00%（4/50）（P<0.05），但两组患者排卵率比较[84.00%（42/50）、80.00%（40/50）]，差异无统计学意义（P>0.05）。 结论 克罗米芬联合二甲双胍治疗多囊卵巢综合征合并不孕患者的临床效果较克罗米芬单独治疗好。

[关键词] 多囊卵巢综合征合并不孕;克罗米芬;二甲双胍;内膜厚度;性激素水平;排卵;妊娠

[中图分类号] R711.6          [文献标识码] B          [文章编号] 1673-9701（2021）06-0079-04

The clinical effect of metformin combined with clomiphene on the patients with polycystic ovary syndrome complicated with infertility

DONG Lingli

Family Planning Service Centre， Heze Women and Children′s Hospital in Shandong Province， Heze   274000， China

[Abstract] Objective To investigate the clinical effect of clomiphene combined with metformin in the patients with polycystic ovary syndrome complicated with infertility. Methods A total of 100 patients with polycystic ovary syndrome complicated with infertility in our hospital from January 2018 to January 2020 were retrospectively analyzed. According to the treatment methods， they were divided into two groups： clomiphene combined with metformin treatment group（combined treatment group， n=50） and single clomiphene treatment group（single treatment group， n=50）. The BMI， FPG， FINS， endometrial thickness， sex hormone levels， ovulation induction time， number of mature follicles， ovulation， pregnancy， and abortion in the two groups were statistically analyzed. Results The degree of decrease in BMI， FPG， FINS and the increase of intimal thickness in the combined treatment group compared before and after treatment were significantly higher than those in the single treatment group（P<0.05）. The degree of decrease in LH， FSH， T， DHEAS， LH/FSH， and the degree of increase in E2 and SHBG levels in the combined treatment group before and after treatment were significantly higher than those in the single treatment group（P<0.05）. The number of mature follicles in the combined treatment group was significantly more than that in the single treatment group（P<0.05）. However， the difference in the number of ovulation induction time between the two groups of patients was not significant（P>0.05）. The pregnancy rate of 50.00%（25/50） in the combined treatment group was significantly higher than that of 20.00%（10/50） in the single treatment group（P<0.05）. Early pregnancy miscarriage rate was 0， significantly lower than that of 8.00%（4/50） in the single treatment group（P<0.05）， but there was no significant difference in ovulation rate between the two groups（84.00%[42/50]， 80.00%[40/50]）（P>0.05）. Conclusion The clinical effect of clomiphene combined with metformin for the patients with polycystic ovary syndrome complicated with infertility is better than clomiphene alone.

[Key words] Polycystic ovary syndrome complicated with infertility; Clomiphene; Metformin; Endometrial thickness; Sex hormone level; Ovulation; Pregnancy

多囊卵巢综合征（Polycystic ovary syndrome，POS）属于一种多样性内分泌紊乱性疾病，育龄期妇女高发，病情呈进行性发展，肥胖、多毛等是其主要临床表现，极易引发女性生殖功能障碍，严重的情况下还会引发子宫内膜癌变，临床较难发现，故常使诊治延误，对患者日常生活质量造成严重不良影响[1]。临床通常采用的治疗方法是提升雌性激素水平，但是缺乏确切的临床疗效，同时极易引发不良反应[2]。为了对POS进行更好的治疗，有效改善患者预后，提升患者妊娠率，改善患者妊娠结局，本研究统计分析了2018年1月至2020年1月我院POS合并不孕患者100例的临床资料，旨在探讨克罗米芬联合二甲双胍治疗POS合并不孕患者的临床效果，现报道如下。……