不同剂量来曲唑对多囊卵巢综合征患者疗效的Meta分析

发布时间：2019-06-20 12:03

【摘要】：目的:系统评价不同剂量的来曲唑(LE)对多囊卵巢综合征(PCOS)患者的疗效,为临床用药提供一定的依据。方法:计算机检索中国知网、维普、万方、Pubmed、The Cochrane Library、Science Direct等数据库,提取出相关的随机对照试验,对各文献进行质量评价后,采用Rev Man5.3软件分析患者的促排卵结局和妊娠结局。结果:1共有9篇文献纳入本研究中,包含816例PCOS患者,共计816个周期;2 Meta分析显示2.5 mg LE与5.0 mg LE在排卵率、流产率、不良事件(多胎妊娠和卵巢过度刺激综合征)发生率及h CG注射日子宫内膜厚度之间的差异均无统计学意义(P0.05),而5.0 mg组的妊娠率高于2.5 mg组,差异具有统计学意义(RR=0.58,P=0.001);5.0 mg组与7.5 mg组在排卵率、周期妊娠率、不良事件发生率、h CG注射日子宫内膜厚度之间的差异均无统计学意义(P0.05)。结论:在临床上对有生育要求的PCOS患者可使用LE促排卵时,5.0 mg剂量有着更高的妊娠率,值得在临床上推广使用。对于效果不佳者,进一步提高剂量并未显示有提高疗效的作用。
[Abstract]:Objective: to systematically evaluate the efficacy of different doses of letrozole (LE) in the treatment of (PCOS) patients with polycystic ovary syndrome (PCOS), and to provide some basis for clinical drug use. Methods: the databases of China knowledge Network, Weipu, Wanfang and Pubmed,The Cochrane Library,Science Direct were searched by computer, and the related randomized controlled trials were extracted. After evaluating the quality of each literature, the ovulatory induction outcome and pregnancy outcome of the patients were analyzed by Rev Man5.3 software. Results: 1 A total of 9 literatures were included in this study, including 816 patients with PCOS, for a total of 816 cycles; 2 Meta analysis showed that there was no significant difference in ovulatory rate, abortion rate, incidence of adverse events (multiple pregnancy and ovarian hyperstimulation syndrome) and intimal thickness on the day of h CG injection between 2.5 mg LE and 5.0 mg LE (P 0.05), but the pregnancy rate in 5.0 mg group was higher than that in 2.5 mg group (RR=0.58,P=0.001). There was no significant difference in ovulatory rate, cycle pregnancy rate and adverse event incidence between 5.0 mg group and 7.5 mg group on the day of, h CG injection (P 0.05). Conclusion: when LE can be used to induce ovulatory in PCOS patients with fertility requirements, the dose of 5.0 mg has a higher pregnancy rate, which is worth popularizing in clinic. For those with poor effect, further increase in dose did not show that it had an effect on improving the curative effect.
【作者单位】：兰州大学第二医院生殖医学中心;甘肃中医学院;
【基金】：国家自然科学基金(编号:81202959) 中央高校重点培育项目(编号:lzujbky-2013-m04)
【分类号】：R711.75

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