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目的比较不同体质量指数(BMI)的多囊卵巢综合征(PCOS)患者使用来曲唑促排卵的临床效果。方法将2014年1月至2015年12月于山东大学附属生殖医院就诊的153例有生育要求的PCOS患者作为研究对象,根据BMI将患者分为肥胖型组71例和非肥胖型组82例。在患者月经第2~4天开始给予来曲唑5 mg,次/d×5 d促排卵监测并指导同房;比较两组间的促排卵效果。结果肥胖型组的血糖、胰岛素、甘油三酯、高密度脂蛋白及总胆固醇水平高于非肥胖型组(P=0.020,<0.001,0.002,<0.001,0.028),而给予绒促性素(HCG)日雌二醇水平低于非肥胖型组,差异均有统计学意义(P=0.026)。两组患者的优势卵泡数、排卵率、HCG日子宫内膜厚度和促黄体生成素、孕酮等激素水平、妊娠率、流产率及活产率等的比较差异均无统计学意义(P>0.05)。结论不同BMI的PCOS患者可选用来曲唑促排卵,其可提高周期排卵率及妊娠率,肥胖型PCOS患者临床效果与非肥胖型患者相似。
Objective To compare the clinical effects of letrozole on ovulation induction in patients with polycystic ovary syndrome (PCOS) with different body mass index (BMI). Methods A total of 153 patients with fertility requiring PCOS from January 2014 to December 2015 were enrolled in the Affiliated Reproductive Hospital of Shandong University. The patients were divided into obesity group (n = 71) and non-obese group (n = 82) according to BMI. In patients with menstruation 2 to 4 days to start letrozole 5 mg, times / d × 5 d ovulation monitoring and guidance of the same room; ovulation promotion effect between the two groups. Results The levels of blood glucose, insulin, triglyceride, high density lipoprotein and total cholesterol in obese group were higher than those in non-obese group (P = 0.020, <0.001, 0.002, <0.001, HCG) day estradiol levels were lower than non-obese group, the difference was statistically significant (P = 0.026). There was no significant difference in the number of dominant follicles, ovulation rate, endometrial thickness on HCG day, hormone levels such as luteinizing hormone and progesterone, pregnancy rate, abortion rate and live birth rate between the two groups (P> 0.05). Conclusion PCOS patients with different BMI may choose letrozole to promote ovulation, which can increase the rate of ovulation and pregnancy rate. The clinical effect of obese patients with PCOS is similar to that of non-obese patients.