摘要
目的 观察来曲唑与克罗米芬诱导排卵的疗效。方法 将排卵障碍患者738例（2026周期）随机分成2组,每组分别应用来曲唑（2.5mg,1次/d,连用5d）或联合人绝经促性腺激素（HMG）、克罗米芬（50mg,1次/d,连用5d）或联合HMG,观察、比较2组的排卵率、妊娠率、流产率等。结果 取消周期率、人绒毛膜促性腺激素（HCG）肌肉注射日平均卵泡直径（MFD）≥15mm的卵泡个数、卵巢过度刺激综合征（OHSS）发生率2组相比差异无统计学意义。单用来曲唑或克罗米芬的优势卵泡出现率：对于非多囊卵巢综合征（PCOS）的排卵异常病例,来曲唑组优于克罗米芬组,而对于PCOS者,来曲唑组则低于克罗米芬组;对于未破裂卵泡黄素化综合征（LUFS）病例,排卵率：来曲唑组高于克罗米芬组;对于小卵泡排卵,肌肉注射HCG日最大卵泡MFD：来曲唑组小于克罗米芬组;妊娠率来曲唑组高于克罗米芬组,而HCG肌肉注射日子宫内膜厚度克罗米芬组薄于来曲唑组,肌肉注射HCG日子宫颈Insler评分克罗米芬组低于来曲唑组,早期流产率克罗米芬组高于来曲唑组;这些指标2组相比差异均有统计学意义。结论 来曲唑在诱导非多囊卵巢综合征患者出现优势卵泡、改善小卵泡排卵者的卵泡发育状况方面劣于克罗米芬,但排卵率、妊娠率优于克罗米芬,早期流产率低于克罗米芬。
Objective To investigate and compare the therapeutic effects of letrozole （LE） and clomiphene citrate （CC） on ovulation induction. Methods 738 women with abnormal ovulation of 2026 cycles were divided into 2 groups randomly. And women of one group were treated with LE （ 2.5 mg qd × 5 d ） with or without human meno- pausal gonadotropin （ HMG ） and women of the other were treated with CC （ 50mg qd × 5 d ） with or without HMG. The ovulation rates, pregnancy rates and abortion rates were compared between 2 groups. Results There was no significant difference in cancellation rate of menstruation cycle, amount of middle follicle dominant （ MFD ） ≥ 15 mm follicle and occurrence rate of ovarian hyperstimulation syndrome （ OHSS ）. Dominant follicles rates of abnormal ovulation without polycystic ovarian syndrome （PCOS） were higher in single LE group than single CC group,but it was just reverse result of abnormal ovulation with PCOS. The ovulation rate of LUFS was higher in LE group than CC group. For the cases of small follicle ovulation cases, MFD of dominant follicle in the day of injection of HCG was lower in LE group than CC group. Pregnancy rates,endometfial thickness and cervix Insler score in the day of injection of HCG were higher in LE group than CC group. And early abortion rates was lower in LE group than CC group. There were significant differences in above parameters of two groups. Conclusion CC is better than LE in inducing dominant follicle of PCOS and small follicle ovulation. However LE is better than CC in elevating the ovulation rates and pregnancy rates and reducing early .abortion rates.
出处
《中国医药》
2007年第6期364-366,共3页
China Medicine
关键词
排卵障碍
诱导排卵
来曲唑
克罗米芬
Abnormal ovulation
Ovulation induction
Letrozole
Clomiphene
