经阴道超声监测下来曲唑联合促性腺激素治疗多囊卵巢综合征不孕的临床研究

白晓慧; 洪露曦

doi:10.16766/j.cnki.issn.1674-4152.003375

经阴道超声监测下来曲唑联合促性腺激素治疗多囊卵巢综合征不孕的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.003375

白晓慧^1, ,,
洪露曦²

1.
温州市中西医结合医院超声科，浙江温州 325000
2.
天台县人民医院超声科，浙江台州 318000

基金项目:

浙江省医药卫生科技计划项目 2020KY1064

详细信息

通讯作者:
白晓慧，E-mail: 65198645@qq.com

中图分类号: R445.1 R711.75
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- 文章访问数: 257
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- PDF下载量: 16
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-30
- 网络出版日期: 2024-03-27

Clinical study of transvaginal ultrasound monitoring of trazole combined with gonadotropin in the treatment of infertility in polycystic ovary syndrome

BAI Xiaohui^{1
, ,},
HONG Luxi²

1.
Department of Ultrasound, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的多囊卵巢综合征主要治疗药物有来曲唑，但单药治疗效果不佳，本研究以阴道超声技术作为疗效的评估手段，探讨来曲唑和促性腺激素药物联用对多囊卵巢综合征不孕患者的疗效。方法选取2022年1—12月温州市中西医结合医院治疗的PCOS患者86例，按照随机数字表法分为观察组(43例)和对照组(43例)，对照组采用来曲唑治疗，观察组采用来曲唑联合人卵泡刺激素进行治疗。采用经阴道超声评估2组患者的卵巢参数，包括卵巢体积、卵巢最大卵泡直径、子宫内膜厚度、卵泡个数，比较2组患者卵巢间质动脉的收缩期峰值流速、搏动指数和阻力指数，比较2组患者促卵泡激素、雌二醇、黄体生成素水平及患者的排卵率和受孕率。结果观察组患者卵巢体积和卵泡个数小于对照组，卵巢最大卵泡直径和子宫内膜厚度大于对照组，卵巢间质动脉收缩期峰值流速、搏动指数和阻力指数均高于对照组，差异均有统计学意义(P＜0.05)。观察组促卵泡激素、雌二醇分别为(7.88±1.26)mIU/mL和(162.32±20.07)pmol/L，均显著高于对照组[(4.42±0.61)mIU/mL和(62.46±9.28)pmol/L，P＜0.05]，观察组黄体生成素显著低于对照组[(6.29±0.78)mIU/mL vs. (18.42±2.15)mIU/mL，P＜0.05]。观察组的排卵率和受孕率均显著高于对照组(P＜0.05)。结论阴道超声监测可良好反馈PCOS患者的治疗情况，促性腺激素药物治疗PCOS可有效提高患者的排卵率和受孕率，具有良好的临床价值。
- 经阴道超声 /
- 促性腺激素药物 /
- 多囊卵巢综合征
Abstract: Objective The main treatment drugs for PCOS are letrozole, but the effect of single drug treatment is not good. This study used vaginal ultrasound technology as a means to evaluate the efficacy of letrozole and gonadotropin drug combination in the treatment of infertility patients with PCOS. Methods A total of 86 patients with PCOS treated in Wenzhou Hospital of Integrated Chinese and Western Medicine from January to December 2022 were selected and divided into observation group (43 cases) and control group (43 cases) according to random number table method. The control group was treated with letrozole, and the observation group was treated with letrozole combined with human follicle stimulating hormone. Ovarian parameters, including ovarian volume, maximum ovarian follicle diameter, endometrial thickness and number of follicles, were evaluated by transvaginal ultrasound. Peak systolic flow rate, pulsation index and resistance index of ovarian interstitial artery were compared between the two groups. Levels of follicle-stimulating hormone, estradiol and luteinizing hormone, ovulation rate and pregnancy rate were compared between the two groups. Results The ovarian volume and number of follicles in observation group were smaller than those in control group, the maximum ovarian follicle diameter and endometrial thickness were larger than those in control group, and the peak systolic flow rate, pulsation index and resistance index of the ovarian interstitial artery were higher than those in control group, with statistical significance (P < 0.05). Follicle stimulating hormone and estradiol in the observation group were (7.88±1.26) mIU/mL and (162.32±20.07) pmol/L, respectively, which were significantly higher than those in the control group [(4.42±0.61) mIU/mL and (62.46±9.28) pmol/L, P < 0.05]. Luteinizing hormone in observation group was significantly lower than that in control group [(6.29±0.78) mIU/mL vs. (18.42±2.15) mIU/mL, P < 0.05]. The ovulation rate and conception rate in the observation group were significantly higher than those of control group (P < 0.05). Conclusion Vaginal ultrasound monitoring can provide good feedback on the treatment of PCOS patients, and gonadotropin drug treatment of PCOS can effectively improve the ovulation rate and pregnancy rate of patients, which has good clinical value.
- Transvaginal ultrasound /
- Gonadotropin drugs /
- Polycystic ovary syndrome

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表 1 2组多囊卵巢综合征患者卵巢参数比较(x±s)

Table 1. Comparison of ovarian parameters between the two groups of patients with polycystic ovary syndrome (x±s)

组别	例数	卵巢体积 (cm³)	卵巢最大卵泡直径(mm)	子宫内膜厚度 (mm)	卵泡数 (个)
观察组	43	7.15±0.37	12.84±3.05	7.42±1.22	7.04±2.03
对照组	43	9.09±0.51	6.73±2.13	5.07±0.96	11.86±3.29
t值		20.190	10.770	9.926	8.176
P值		＜0.001	＜0.001	＜0.001	＜0.001

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表 2 2组多囊卵巢综合征患者卵巢间质动脉指标比较(x±s)

Table 2. Comparison of ovarian stromal artery indexes between the two groups of patients with polycystic ovary syndrome (x±s)

组别	例数	PSV(cm/s)	PI	RI
观察组	43	11.99±2.31	0.91±0.32	0.62±0.08
对照组	43	21.05±2.35	0.49±0.22	0.48±0.10
t值		18.029	7.092	7.169
P值		＜0.001	＜0.001	＜0.001

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表 3 2组多囊卵巢综合征患者性激素水平比较(x±s)

Table 3. Comparison of sex hormone levels between the two groups of patients with polycystic ovary syndrome (x±s)

组别	例数	促卵泡激素 (mIU/mL)	雌二醇 (pmol/L)	黄体生成素 (mIU/mL)
观察组	43	7.88±1.26	162.32±20.07	6.29±0.78
对照组	43	4.42±0.61	62.46±9.28	18.42±2.15
t值		16.207	29.615	34.778
P值		＜0.001	＜0.001	＜0.001

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表 4 2组多囊卵巢综合征患者排卵及受孕情况比较[例(%)]

Table 4. Comparison of ovulation and pregnancy in two groups of patients with polycystic ovary syndrome [cases (%)]

组别	例数	排卵	受孕
观察组	43	39(90.70)	23(53.49)
对照组	43	22(51.16)	8(18.60)
χ²值		16.108	11.217
P值		＜0.001	＜0.001

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