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目的比较克罗米芬、来曲唑联合醋酸曲普瑞林(GnRH-a)诱导排卵在多囊卵巢综合征(PCOS)不孕患者促排卵中的应用效果。方法 60例PCOS不孕患者随机分为二组,克罗米芬组30例采用克罗米芬促排卵方案,来曲唑组30例采用来曲唑促排卵方案,当主导卵泡平均直径达18~22mm时,二组均采用GnRH-a0.1mg,皮下注射,以诱导排卵,比较二组月经第十天>14mm卵泡个数、子宫内膜厚度、GnRH-a注射日子宫内膜的厚度、成熟卵泡个数、血清黄体生成素(LH)、雌激素(E2)水平、排卵率、妊娠率,卵巢过度刺激综合征(OHSS)发生率。结果克罗米芬组患者第十天>14mm卵泡数多、子宫内膜厚度薄,差异有统计学意义(P<0.05)。GnRH-a日克罗米芬组成熟卵泡数多、子宫内膜厚度薄、血E2浓度高,差异有统计学意义(P<0.05)。但血LH水平差异无统计学意义(P>0.05)。二组比较排卵率、妊娠率差异均无统计学意义,克罗米芬组OHSS发生率高于来曲唑组,差异有统计学意义(P<0.05)。结论来曲唑联合GnRH-a促排卵可以降低PCOS患者促排卵治疗中OHSS发生的危险。
Objective To compare the effect of clomiphene and letrozole combined with triptorelin acetate (GnRH-a) on ovulation induction in women with polycystic ovary syndrome (PCOS) infertility. Methods Sixty cases of PCOS infertility were randomly divided into two groups. In the clomiphene citrate group, 30 cases were treated with clomiphene for ovulation induction. In the letrozole group, 30 cases were treated with letrozole for ovulation induction. When the dominant follicles reached 18-22 mm in diameter, Two groups were used GnRH-a0.1mg, subcutaneous injection to induce ovulation, the second group of menstruation> 14mm follicles on the tenth day, endometrial thickness, GnRH-a endometrial thickness, the number of mature follicles , Serum luteinizing hormone (LH), estrogen (E2), ovulation rate, pregnancy rate and ovarian hyperstimulation syndrome (OHSS) incidence. Results In the clomiphene citrate group, the number of follicles> 14mm was more on the tenth day, and the thickness of the endometrium was thinner. The difference was statistically significant (P <0.05). The number of mature follicles in GnRH-a day clomiphene group was more, the thickness of endometrium was thinner and the concentration of E2 in blood was higher. The difference was statistically significant (P <0.05). However, there was no significant difference in blood LH levels (P> 0.05). There was no significant difference in ovulation rate and pregnancy rate between the two groups. The incidence of OHSS in clomiphene citrate group was higher than that in letroxazole group (P <0.05). Conclusion Letrozole combined with GnRH-α ovulation can reduce the risk of OHSS in ovulation induction treatment in patients with PCOS.