目的 评价维生素D联合二甲双胍及炔雌醇环丙孕酮治疗多囊卵巢综合征(PCOS)不孕的临床疗效。方法 选择2017年5月—2019年6月在本院妇科门诊就治的PCOS患者72 例,年龄21～38岁,不孕年限2～5年,按随机数字表法分为观察组和对照组,每组36例。观察组给予维生素D联合二甲双胍及炔雌醇环丙孕酮治疗,对照组给予二甲双胍及炔雌醇环丙孕酮治疗,两组均连续服药3个周期后再促排卵治疗3个周期,分析比较两组患者治疗前后基础血清促卵泡激素(FSH)、黄体生成素(LH)、睾酮(T)、LH/FSH、抗苗勒管激素(AMH)、维生素D(25(OH)D3)水平,胰岛素抵抗率以及促排卵妊娠结局。结果 治疗后两组间LH、T、LH/FSH、AMH水平比较均较治疗前降低,且观察组LH、T、LH/FSH、AMH水平[依次为(6.31±0.83)IU/L,(1.34±0.03)nmol/L,(1.17±0.06),(2.27±1.31)ng/mL]较对照组[(7.83±0.91)IU/L,(1.99±0.09)nmol/L,(1.89±0.07),(3.42±1.35)ng/mL]降低更加明显,差异均有统计学意义;观察组25(OH)D3水平[(44.76±7.21)ng/mL]较对照组[(20.07±6.53)ng/mL]有明显升高,差异有统计学意义;治疗后观察组胰岛素抵抗率(19.4%)与对照组(75.0%)比较明显下降,差异有统计学意义;治疗后观察组月经恢复率(97.2%)、排卵率(88.9%)及妊娠率(72.2%)与对照组(77.8%、61.1%、44.4%)比较,差异有统计学意义。结论 维生素D联合二甲双胍及炔雌醇环丙孕酮治疗能有效改善PCOS不孕患者的内分泌激素及代谢状况,降低胰岛素抵抗发生率,提高妊娠结局,值得临床应用。
关键词
维生素D /
二甲双胍 /
炔雌醇环丙孕酮 /
多囊卵巢综合征(PCOS)
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参考文献
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脚注
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基金
广东省自然科学基金(10151008010000002)
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