目的:比较来曲唑(LE)和克罗米酚(CC)对PCOS患者促排卵疗效,探讨LE治疗PCOS的临床效果。方法:经达英-35和二甲双胍治疗后的PCOS患者56例拟行促排卵治疗,分为LE组30例和CC组26例,分别于月经第5日开始口服LE和CC。阴道超声监测卵泡发育,当卵泡直径≥18mm时,皮下注射重组人绒毛膜促性腺激素(HCG)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),并观察子宫内膜厚度、子宫动脉血流情况、排卵率、LUF发生率及妊娠率等。结果:LE组的周期排卵率、妊娠率及LUF发生率与CC组相比差异无统计学意义(P>0.05);LE组HCG日血清E2水平显著低于CC组(P<0.05),但子宫内膜厚度较CC组厚(P<0.05),且HCG日优势卵泡数、子宫动脉血流情况及单卵泡排卵率均优于CC组(P<0.05)。结论:在PCOS促排卵治疗中,LE促单卵泡排卵率高,子宫内膜容受性好,可降低多胎及OHSS的发生率并带来良好的妊娠率,更适合应用于PCOS患者的促排卵治疗。 Objective: To compare the efficacy of letrozole (LE) and clomiphene citrate (CC) in promoting ovulation in patients with PCOS, and to explore the clinical effect of LE in the treatment of PCOS. Methods: Fifty-six patients with PCOS who were treated with Ying-35 and metformin were enrolled in ovulation induction treatment. They were divided into LE group (n = 30) and CC group (n = 26). LE and CC were orally taken on the 5th day of menstruation. Vaginal ultrasound monitoring of follicular development, when the follicle diameter ≥ 18mm, subcutaneous injection of recombinant human chorionic gonadotropin (HCG) induced ovulation. The LHG, estradiol (E2) and testosterone (T) were measured on elbow vein at HCG day, and the thickness of endometrium, uterine arterial blood flow, ovulation rate, LUF incidence and pregnancy rate . Results: The ovulation rate, pregnancy rate and LUF incidence in LE group were not significantly different from those in CC group (P> 0.05). The serum E2 level of HCG group in LE group was significantly lower than that in CC group (P <0.05) The thickness of endometrium was thicker than that of CC group (P <0.05), and the number of dominant follicles, uterine artery blood flow and ovulation rate of single follicles in HCG group were better than CC group (P <0.05). Conclusions: In ovulation induction of PCOS, ovulation rate of single follicle is high, endometrial receptivity is good, which can reduce the incidence of multiple births and OHSS and bring about good pregnancy rate, and is more suitable for ovulation induction in PCOS patients treatment.