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目的探讨克罗米芬联合人绒毛膜促性腺激素(HCG)对多囊卵巢综合征(PCOS)不孕患者促排卵的临床效果。方法选取62例PCOS所致不孕女性,随机分成对照组与观察组各31例。对照组予单纯克罗米芬治疗,观察组在此基础上再予HCG治疗。检测治疗前后血清生殖内分泌激素水平,评估子宫内膜容受性,观察并记录排卵、妊娠等结局指标,比较治疗效果。结果与治疗前比较,2组T、LH水平均显著降低(P<0.05),FSH、E_2水平无显著变化(P>0.05),子宫内膜螺旋动脉PI、RI均显著升高(P<0.01),子宫内膜厚度显著增厚(P<0.01);与对照组比较,观察组T、LH水平均显著较低(P<0.05),子宫内膜螺旋动脉PI、RI均显著较高(P<0.01),子宫内膜厚度显著较厚(P<0.01),排卵率、卵泡生长速率以及临床妊娠率均显著较高(P<0.05),早期流产率显著较低(P<0.05),临床总有效率显著较高(P<0.05)。结论克罗米芬联合HCG治疗PCOS所致不孕症效果优于单用克罗米芬。
Objective To investigate the clinical effect of clomiphene in combination with human chorionic gonadotropin (HCG) on ovulation induction in women with polycystic ovary syndrome (PCOS) infertility. Methods Sixty-two infertile women with PCOS were selected and randomly divided into control group and observation group with 31 cases each. The control group was treated with clomiphene citrate alone and the observation group was given HCG again. The levels of serum endocrine hormone before and after treatment were measured, endometrial receptivity was evaluated, the ovulation and pregnancy outcomes were observed and recorded, and the therapeutic effect was compared. Results Compared with those before treatment, the levels of T and LH were significantly decreased in both groups (P <0.05) and the levels of FSH and E_2 were not significantly changed (P> 0.05). The PI and RI of the endometrial spiral arteries were significantly increased (P <0.01) (P <0.01). Compared with the control group, the levels of T and LH in the observation group were significantly lower (P <0.05), and the PI and RI in the endometrial spiral artery were significantly higher (P <0.01) (P <0.01). The thickness of endometrium was significantly thicker (P <0.01), the ovulation rate, follicular growth rate and clinical pregnancy rate were significantly higher (P <0.05), the rate of early miscarriage was significantly lower (P <0.05) The total effective rate was significantly higher (P <0.05). Conclusion Clomiphene combined with HCG treatment of infertility caused by PCOS better than single clomiphene citrate.