[1]焦婷婷,李建华,郝翊,等.促性腺激素释放激素拮抗剂联合来曲唑治疗卵巢过度刺激综合征的临床分析[J].中国计划生育和妇产科,2017,(11):34-37.
　JIAO Ting-ting,LI Jian-hua,HAO Yi,et al.Clinical analysis of GnRH-a combined with letrozole in the treatment of ovarian hyperstimulation syndrome[J].Chinese Journal of Family Planning & Gynecotokology,2017,(11):34-37.
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促性腺激素释放激素拮抗剂联合来曲唑治疗卵巢过度刺激综合征的临床分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年11期
页码:
34-37
栏目:
论著与临床
出版日期:
2017-11-25

文章信息/Info

Title:
Clinical analysis of GnRH-a combined with letrozole in the treatment of ovarian hyperstimulation syndrome
作者:
焦婷婷; 李建华; 郝翊; 张水文*
陆军总医院生殖医学中心
Author(s):
JIAO Ting-ting; LI Jian-hua; HAO Yi;  ZHANG Shui-wen*
Reproductive Medicine Center，PLA Army General Hospital，Beijing 10007，P.R.China
关键词:
卵巢过度刺激综合征; 促性腺激素释放激素拮抗剂; 来曲唑
Keywords:
OHSS; GnRH- a; letrozole
分类号:
R 73731
摘要:
目的探讨卵巢过度刺激综合征(ovarian hyperstimulation syndrome，OHSS)高危患者在取卵术后应用促性腺激素释放激素拮抗剂（gonadotrophin releasing hormone- antagonist， GnRH-a）联合来曲唑治疗的临床效果，寻找OHSS的有效预防和治疗方法。方法回顾性分析陆军总医院生殖医学中心2016年1月至2017年3月行体外受精-胚胎移植(invitro fertilization-embryo transfer， IVF-ET)助孕，因具有OHSS高危因素［人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）日血清雌二醇(estradiol，E2 )＞3 000 pg /mL和/或获卵数≥15个］而取消新鲜周期胚胎移植的患者共109例。其中术后应用GnRH-a联合来曲唑治疗58例为研究组，51例采取临床观察的方式为对照组。观察两组患者OHSS的发生率，E2下降的水平，以及中、重度OHSS发生的比例。结果研究组E2下降水平在取卵术后第2 d和第4 d大于对照组，轻度OHSS的发生率高于对照组，中度OHSS的发生率低于对照组，差异均有统计学意义（P＜005）；重度OHSS的发生率两组比较差异无统计学意义（P＞005）。结论对具有OHSS高危因素患者在取卵术后应用GnRH-a联合来曲唑能降低雌激素水平，并促使中度OHSS向轻度OHSS转化，减少中度OHSS的发生，可有效预防和治疗OHSS。
Abstract:
ObjectiveTo investigate the clinical efficacy of gonadotropin-releasing hormone antagonist（GnRH-a） combined with letrozole after ovariectomy in patients with high risk of ovarian hyperstimulation syndrome(OHSS). And to find effective prevention and treatment of OHSS. MethodsData of 109 cases subjected to in vitro fertilization and embryo transfer(IVF-ET) in PLA Army General Hospital from January 2016 to March 2017 who had to cancel the fresh cycle of embryo transfer due to the OHSS risk factors［serum estradiol (E2)> 3000 pg/mL and/or the number of eggs≥15 on hCG day］ was analyzed retrospectively. After surgery, 58 cases treated with GnRH-a combined with letrozole were the study group and 51 cases with clinical observation were the control group. The incidence of OHSS, the level of E2 decline, and the proportion of moderate and severe OHSS of the two groups were observed. ResultsOf the study group, The level of E2 was higher than that of the control group in 2 d and 4 d after ovariectomy, the incidence of mild OHSS was higher than that of the control group, while the incidence of moderate OHSS was lower than that of the control group(P＜005). There was no significant difference in the incidence of severe OHSS between the two groups(P＞005).ConclusionThe use of GnRH-a combined with letrozole can reduce the estrogen level after ovariectomy in patients with high risk factors. Promote the moderate OHSS to mild OHSS transformation and reduce the occurrence of moderate OHSS can effectively prevent and treat OHSS.

参考文献/References:

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（项目编号：81401271）
更新日期/Last Update: 2017-11-25