| 殷科,刘云,黄璐,等.来曲唑与地塞米松联合治疗多囊卵巢综合征的疗效及对血清单核细胞趋化蛋白?1、抗苗勒管激素水平的影响[J].安徽医药,2019,23(10):2069-2072. |
| 来曲唑与地塞米松联合治疗多囊卵巢综合征的疗效及对血清单核细胞趋化蛋白?1、抗苗勒管激素水平的影响 |
| Clinical observation of the combination of letrozole and dexamethasone in the treatment of polycystic ovary syndrome and its effect on serum MCP?1 and AMH levels |
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| DOI：10.3969/j.issn.1009?6469.2019.10.042 |
| 中文关键词: 多囊卵巢综合征 来曲唑 地塞米松 趋化因子 CCL2 抗苗勒管激素 |
| 英文关键词: Polycystic ovarian syndrome Letrozole Dexamethasone Chemokine CCL2 Anti miillerian hormone |
| 基金项目:江苏省无锡市医院管理中心科研项目(YGZXM1508) |
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| 中文摘要: |
| 目的探究来曲唑与地塞米松联合治疗多囊卵巢综合征( PCOS)的临床疗效及对血清单核细胞趋化蛋白 ?1(MCP?1)、抗苗勒管激素( AMH)水平的影响。方法选择 2017年 3月至 2018年 3月无锡市妇幼保健院 PCOS病人 90例，按入院时间区组随机化，分为两组。对照组 45例口服来曲唑每次 2.5 mg，每日 1次，服 5d。治疗组 45例口服来曲唑每次 2.5 mg，每日 1次，服 5 d。月经后第 1天服用地塞米松，每次 0.75 mg，每日 1次，排卵后停止服用。比较两组病人的临床疗效、促排卵情况以及不良反应发生情况。检测并比较两组血清 MCP?1、AMH水平。结果经过治疗后两组的黄体生成素和睾酮均显著降低，治疗组的血清黄体生成素和睾酮水平均显著低于对照组( P＜0.05)。治疗组的雌二醇用量显著低于对照组( P＜0.05)而成熟卵泡个数以及最大卵泡直径均显著高于对照组( P＜0.05)。治疗组的妊娠率 44.44%(20/45)显著高于对照组 24.44%(11/45)(，P＜0.05)，治疗组早期流产率 5.00%(1/20)与对照组 18.18%(2/11)差异无统计学意义(P＞0.05)。治疗后 MCP?1、AMH水平均显著降低，治疗组的 MCP?1、AMH水平［(187.53±29.66)pg/mL，(3.85±0.67)nmol/L］均显著低于对照组［(245.31±33.83)pg/mL，(4.93±0.72)nmol/L］(P＜0.05)。两组不良反应比较差异无统计学意义( χ2＝0.450，P＝0.502)。结论来曲唑联合地塞米松可能通过控制 MCP? 1、AMH水平，更有效地调激素水平，促进排卵，改善预后。 |
| 英文摘要: |
| Objective To investigate the combination of letrozole and dexamethasone in the treatment of polycystic ovary syndrome(PCOS)and its effect on serum monocyte chemoattractant protein?1(MCP?1)and anti?Mullerian hormone(AMH)levels.Meth? ods Ninety patients with PCOS treated at Wuxi Maternal and Child Health Hospital from March 2017 to March 2018 were ran?domly assigned into two groups according to the time of admission.The control group was treated with 2.5 mg letrozole each time， once a day for 5 d and the treatment group was treated with letrozole(2.5 mg，once a day，for 5 d)and dexamethasone(0.75 mg， once a day，discontinued after ovulation.The clinical efficacy，ovulation induction and adverse reactions were compared between thetwo groups.Serum MCP?1 and AMH levels were measured and compared between the two groups.Results Both luteinizing hor? mone(LH)and testosterone(T)were significantly lower in both groups after treatment.Serum LH and T levels in the treatmentgroup were significantly lower than those in the control group(P＜0.05).The amount of estradiol in the treatment group was signifi? cantly lower than that in the control group(P＜0.05). The number of mature follicles and the maximum follicle diameter in the treatment group were significantly higher than those in the control group(P＜0.05). The pregnancy rate of the treatment group(44.44%，20/45)was significantly higher than that of the control group(24.44%，11/45，P＜0.05).There was no significant differ? ence in first trimester abortion rate between the treatment group(5.00%，1/20)and the control group(18.18%，2/11，P＞0.05).Af? ter treatment，the levels of MCP?1 and AMH were significantly decreased.The MCP?1 and AMH levels in the treatment group［( 187.53±29.66)pg/mL，(3.85±0.67)nmol/L］were significantly lower than those in the control group［( 245.31±33.83)pg/mL，(4.93±0.72)nmol/L］( P＜0.05).There was no significant difference in adverse reactions between the two groups(χ2＝0.450，P＝ 0.502).Conclusion Letrozole combined with dexamethasone can more effectively regulate hormone levels，promote ovulation and improve prognosis by controlling the levels of MCP?1 and AMH. |
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