摘要
目的探究低分子肝素辅助来曲唑治疗多囊卵巢综合征(PCOS)致不孕的临床疗效及对患者子宫内膜容受性的影响。方法选取菏泽市巨野县妇幼保健院2022年1月—2023年3月收治的74例PCOS致不孕患者为研究对象,采用随机数字表法将其分为对照组及观察组,每组37例。对照组采用来曲唑治疗,观察组采用低分子肝素联合来曲唑治疗,两组均持续治疗3个月经周期。比较两组患者的临床疗效、血清性激素水平、子宫内膜容受性、排卵和妊娠情况及不良反应发生情况。结果观察组治疗总有效率、妊娠率、排卵率分别为94.59%、78.39%、91.90%,均高于对照组的75.67%、51.35%、72.97%,组间差异有统计学意义(P<0.05)。观察组血清卵泡刺激素、黄体生成素、雌二醇水平分别为(18.45±3.45)mIU/mL、(28.45±4.37)mIU/mL、(210.22±20.23)pg/mL,均高于对照组的(5.07±1.29)m IU/mL、(26.37±4.12)m IU/mL、(162.52±18.42)pg/mL,组间差异有统计学意义(P<0.05)。观察组子宫内膜厚度为(9.76±1.04)mm,厚于对照组的(7.35±0.93)mm,子宫内膜螺旋动脉搏动指数、阻力指数分别为(1.28±0.23)、(0.56±0.13),均低于对照组的(1.72±0.34)、(0.67±0.11),组间差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论PCOS致不孕患者采用低分子肝素辅助来曲唑治疗的效果显著,可增加子宫内膜容受性,调节血清性激素水平,有利于患者排卵及妊娠情况的改善,且安全性较高。
Objective To investigate the clinical efficacy of low molecular weight heparin assisted letrozole in the treatment of infertility induced by polycystic ovary syndrome(PCOS)and its influence on patients'endometrial receptivity.Methods 74 infertility patients caused by PCOS admitted to Juye County Maternal and Child Health Hospital of Heze city from January 2022 to March 2023 were selectedas the research objects and were divided into a control group and an observation group by random number table method,with 37 cases in each group.The control group was treated with letrozole,and the observation group was treated with low molecular weight heparin combined with letrozole.Both groups received continuous treatment for 3 menstrual cycles.The clinical efficacy,serum sex hormone levels,endometrial receptivity,ovulation and pregnancy and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate,pregnancy rate and ovulation rate of the observation group were 94.59%,78.39%and 91.90%,respectively,which were higher than 75.67%,51.35%and 72.97%of the control group,and the differences between groups were statistically significant(P<0.05).The levels of FSH,luteinizing hormone and estradiol in the observation group were(18.45±3.45)mIU/mL,(28.45±4.37)mIU/mL and(210.22±20.23)pg/mL,respectively.It was higher than(5.07±1.29)mIU/mL,(26.37±4.12)mIU/mL,(162.52±18.42)pg/mL in control group,and the differences between groups were statistically significant(P<0.05).The endometrial thickness of the observation group was(9.76±1.04)mm,which was thicker than that of the control group(7.35±0.93)mm.The spiral artery pulse index and resistance index of the endometrial were(1.28±0.23)and(0.56±0.13),respectively,which were lower than that of the control group(1.72±0.34)and(0.67±0.11).The differences between groups were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The effect of low molecular weight heparin assisted letrozole on infertility caused by PCOS is significant,which can increase endometrial receptivity and regulate serum sex hormone levels,and is conducive to the improvement of ovulation and pregnancy in patients with high safety.
作者
朱美丽
ZHU Meili(Department of Obstetrics and Gynecology,Juye County Maternal and Child Health Hospital of Heze city,Heze Shandong,274900,China)
出处
《反射疗法与康复医学》
2024年第7期141-144,共4页
Reflexology And Rehabilitation Medicine
关键词
多囊卵巢综合征
不孕
低分子肝素
来曲唑
临床疗效
子宫内膜容受性
Polycystic ovary syndrome
Infertility
Low molecular weight heparin
Letrozole
Clinical efficacy
Endometrial receptivity
