雷洛昔芬与氯米芬治疗多囊卵巢综合征合并不孕症的临床效果比较

发布时间：2018-05-20 20:41

  本文选题：雷洛昔芬 + 氯米芬　； 参考：《中国药房》2017年23期

【摘要】：目的:比较雷洛昔芬与氯米芬治疗多囊卵巢综合征(PCOS)合并不孕症的临床效果。方法:采用回顾性研究法,选择2012年6月-2015年2月在我院治疗的137例PCOS合并不孕症患者的临床资料,按照治疗方案不同分为雷洛昔芬组(70例)和氯米芬组(67例)。雷洛昔芬组患者于月经周期第5天口服盐酸雷洛昔芬片120 mg,qd,连服5 d;氯米芬组患者于月经周期第5天口服枸橼酸氯米芬胶囊100 mg,qd,连服5 d。两组患者均于月经周期第12天行B超检测卵泡直径及子宫内膜发育情况,当子宫内膜厚度≥7 mm、不少于1个卵泡直径≥18 mm时,于腹部皮下注射醋酸曲普瑞林注射液0.1 mg诱发排卵,48 h后B超确认排卵;黄体功能不足者酌情口服地屈孕酮10 mg,q12 h,服用至排卵后15 d。比较两组患者醋酸曲普瑞林注射当日的子宫内膜厚度、直径≥18 mm的卵泡数、卵泡成熟时间,治疗前与醋酸曲普瑞林注射当日的血清性激素水平,排卵情况,随访期间的结局指标,以及不良反应发生情况。结果:雷洛昔芬组患者的子宫内膜厚度明显大于氯米芬组,直径≥18 mm的卵泡数明显多于氯米芬组,卵泡成熟时间明显短于氯米芬组,差异均有统计学意义(P0.05)。治疗前,两组患者血清孕激素(P)、雌二醇(E2)、卵泡雌激素(FSH)和黄体生存素(LH)水平比较,差异均无统计学意义(P0.05);醋酸曲普瑞林注射当日,两组患者血清P、E2、FSH与治疗前比较,差异均无统计学意义(P0.05),但血清LH水平均明显降低,且雷洛昔芬组的LH水平明显低于氯米芬组,差异均有统计学意义(P0.05)。雷洛昔芬组患者的排卵率明显高于氯米芬组,差异有统计学意义(P0.05);两组患者的妊娠率、流产率、继续妊娠率比较,差异均无统计学意义(P0.05)。两组患者总不良反应发生率比较(5.71%vs.8.96%),差异无统计学意义(P0.05)。结论:雷洛昔芬较氯米芬有更好的促排卵效应,可有效改善PCOS合并不孕症患者的性激素水平,不良反应较少,且与氯米芬的远期临床效应类似。
[Abstract]:Objective: to compare the clinical effects of raloxifen and clomiphene in the treatment of polycystic ovary syndrome (PCOS) with infertility. Methods: the clinical data of 137 patients with PCOS combined with infertility treated in our hospital from June 2012 to February 2015 were retrospectively studied. According to different treatment schemes, they were divided into two groups: raloxifene group (n = 70) and clomiphene group (n = 67). The patients in the raloxifene group received oral administration of loroxifene hydrochloride 120 mg / g QD for 5 days on the 5th day of menstrual cycle, and clomiphene group took 100 mg clomiphene citrate capsule for 5 days on the 5th day of menstrual cycle. The follicle diameter and endometrial development were measured by B-ultrasound on the 12th day of menstrual cycle. When the thickness of endometrium was 鈮，

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