促性腺激素释放激素拮抗剂在卵巢过度刺激综合征治疗中应用价值研究
|
摘要
目的探讨促性腺激素释放激素拮抗剂在卵巢过度刺激综合征治疗中的应用价值。方法选取北部战区总医院生殖医学中心2016年1—4月收治的36例卵巢过度刺激综合征患者为研究对象。按照随机数字表法将患者分入两组,每组18例。A组患者接受常规治疗,B组患者在常规治疗基础上加用促性腺激素释放激素拮抗剂。比较两组患者促黄体激素、雌二醇及获卵数、受精数、优质胚胎数。结果两组患者均未出现严重并发症。B组促黄体激素为(2. 6±1. 3)的U/L,明显低于A组的(4. 1±1. 5) U/L,差异有统计学意义(P <0. 05)。B组雌二醇为(986. 4±648. 5) U/L,明显低于A组的(1623. 5±632. 6) U/L,差异有统计学意义(P <0. 05)。B组获卵数、受精数、优质胚胎数分别为(36. 5±4. 1)个、(22. 8±5. 2)个、(9. 5±2. 2)个,均多于A组的(22. 1±4. 3)个、(13. 4±5. 3)个、(6. 4±2. 3)个,差异有统计学意义(P <0. 05)。结论促性腺激素释放激素拮抗剂治疗卵巢过度刺激综合征安全有效,可控制疾病进展,也可用于疾病预防。
Objective To investigate the effects of gonadotropin-releasing hormone( GnR) antagonists in ovarian hyperstimulation syndrome( OHSS) application and safety of patients. Methods A retrospective study was performed on 36 cases of patients with OHSS who were admitted from January to April 2016. Patients were randomly divided into the Group A and Group B,with 18 cases in each group. Patients in the Group A were performed conventional therapy,the others in the Group B were performed GnR on the conventional therapy. Luteinizinghormone,estradiol,number of eggs obtained,number of fertilization and number of high-quality embryos were compared between the two groups. Results No serious complications occurred in either group. Luteinizing hormone( 2. 6 ± 1. 3) U/L in Group B was significantly lower than( 4. 1 ± 1. 5) U/L in Group A,and the difference was statistically significant( P < 0. 05). Estradiol in Group B was( 986. 4 ± 648. 5) U/L,significantly lower than( 1 623. 5 ± 632. 6) U/L in Group A( P < 0. 05). The number of eggs obtained,fertilized and high-quality embryos in Group B were( 36. 5 ± 4. 1),( 22. 8 ± 5. 2) and( 9. 5 ± 2. 2),respectively,which were more than those in Group A( 22. 1 ± 4. 3),( 13. 4 ± 5. 3) and( 6. 4 ± 2. 3),with statistically significant differences( P < 0. 05).Conclusion GnR antagonists are safe and effective in the treatment of OHSS,which can control the disease progression and also be used for disease prevention.
Objective To investigate the effects of gonadotropin-releasing hormone( GnR) antagonists in ovarian hyperstimulation syndrome( OHSS) application and safety of patients. Methods A retrospective study was performed on 36 cases of patients with OHSS who were admitted from January to April 2016. Patients were randomly divided into the Group A and Group B,with 18 cases in each group. Patients in the Group A were performed conventional therapy,the others in the Group B were performed GnR on the conventional therapy. Luteinizinghormone,estradiol,number of eggs obtained,number of fertilization and number of high-quality embryos were compared between the two groups. Results No serious complications occurred in either group. Luteinizing hormone( 2. 6 ± 1. 3) U/L in Group B was significantly lower than( 4. 1 ± 1. 5) U/L in Group A,and the difference was statistically significant( P < 0. 05). Estradiol in Group B was( 986. 4 ± 648. 5) U/L,significantly lower than( 1 623. 5 ± 632. 6) U/L in Group A( P < 0. 05). The number of eggs obtained,fertilized and high-quality embryos in Group B were( 36. 5 ± 4. 1),( 22. 8 ± 5. 2) and( 9. 5 ± 2. 2),respectively,which were more than those in Group A( 22. 1 ± 4. 3),( 13. 4 ± 5. 3) and( 6. 4 ± 2. 3),with statistically significant differences( P < 0. 05).Conclusion GnR antagonists are safe and effective in the treatment of OHSS,which can control the disease progression and also be used for disease prevention.
引文
[1]阮恒超,黄荷凤,金帆.不同方案超排卵下小鼠子宫内膜种植窗期整合素β3的表达[J].中华医学杂志,2014,12(10):105-106.
[2]高贵花,魏兆莲,曹云霞.不同控制性促排卵方案对多囊卵巢综合症患者体外受精-胚胎移植治疗效果的影响[J].中国妇幼保健,2014,23(36):159-161.
[3]田莉,鹿群,沈浣,等.GnRH拮抗剂配伍HMG方案对卵巢低反应患者胚胎移植治疗结局分析[J].中国妇产科临床杂志,2014,9(1):38-40.
[4]崔艳国,全松,朱亮,等.高龄不孕女性体外受精周期中GnRH拮抗剂与激动剂应用效果比较[J].海南医学,2015,28(10):123-125.
[5]朱亮,邢福祺.GnRH_A用药方案及其在控制性超促排卵中的应用进展[J].国际生殖健康与计划生育杂志,2007,26(4):183-186.
[6]Rinaldi L,Lisi F,Selman H.Mild/minimal stimulation protocol for ovarian stimulation of patients at high risk of developing ovarian hyperstimulation syndrome[J].J EndocrinolInvest,2014,37(1):65-70.
[7]Lin H,Li Y,Li L,et al.Is a GnRH antagonist protocol better in P-COS patients?A meta-analysis of RCTs[J].PLo S One,2014,9(3):e91796.
[8]Xiao J,Chen S,Zhang C,et al.Effectiveness of GnRH antagonist in the treatment of patients with polycystic ovary syndrome undergoing IVF:a systematic review and meta analysis[J].Gynecol Endocrinol,2015,29(3):187-191.
[9]张四友,郑敏.促性腺激素释放激素激动剂替代绒毛膜促性腺激素诱导排卵预防卵巢过度剌激综合征的初步观察[J].中华医学杂志,2014,1(3):273-275.
[10]阳翎.多剂量促性腺激素释放激素拮抗剂在体外受精一胚胎移植促超排卵中的应用效果[J].中华医学杂志,2015,24(4):535.
[11]刁飞扬,王嫜,黄洁,等.拮抗剂方案中应用促性腺激素释放激素激动剂诱发卵母细胞成熟后不同黄体支持方案对妊娠结局的影响-一项提前终止的前瞻随机临床对照研究[J].生殖医学杂志,2013,22(10):797-801.
[12]肖劲松,陈双陨,张春莲.促性腺激素释放激素拮抗剂在体外受精-胚胎移植中有效性的系统性评价[J].中国循证医学杂志,2010,10(12):1432-1438.
[13]周灿权,庄广伦.卵巢对超促排治疗的反应过度与不足[J].生殖医学杂志,2014,7(4):218.
[14]陈霞,赵军招,王佩玉,等.不同剂量hCG对体外受精-胚胎移植结局的影响[J].温州医学院学报,2015,42(2):154-156.
[15]Onofriescu A,Bors A,Luca A,et al.GnRH Antagonist IVF Protocol in PCOS[J].Curr Health Sci J,2015,39(1):20-25.
[16]Pundir J,Sunkara SK,El-Toukhy T,et al.Meta-analysis of GnRHantagonist protocols:do they reduce the risk of OHSS in PCOS[J].Reprod Biomed Online,2015,24(1):6-22.
[17]Gardner DK,Weissman A,Howles CM,et al.Textbook of assisted reproduetive technologies(laboratory and clinical perspectives),third edition[M].UK:Informa Press,2015:761.
[2]高贵花,魏兆莲,曹云霞.不同控制性促排卵方案对多囊卵巢综合症患者体外受精-胚胎移植治疗效果的影响[J].中国妇幼保健,2014,23(36):159-161.
[3]田莉,鹿群,沈浣,等.GnRH拮抗剂配伍HMG方案对卵巢低反应患者胚胎移植治疗结局分析[J].中国妇产科临床杂志,2014,9(1):38-40.
[4]崔艳国,全松,朱亮,等.高龄不孕女性体外受精周期中GnRH拮抗剂与激动剂应用效果比较[J].海南医学,2015,28(10):123-125.
[5]朱亮,邢福祺.GnRH_A用药方案及其在控制性超促排卵中的应用进展[J].国际生殖健康与计划生育杂志,2007,26(4):183-186.
[6]Rinaldi L,Lisi F,Selman H.Mild/minimal stimulation protocol for ovarian stimulation of patients at high risk of developing ovarian hyperstimulation syndrome[J].J EndocrinolInvest,2014,37(1):65-70.
[7]Lin H,Li Y,Li L,et al.Is a GnRH antagonist protocol better in P-COS patients?A meta-analysis of RCTs[J].PLo S One,2014,9(3):e91796.
[8]Xiao J,Chen S,Zhang C,et al.Effectiveness of GnRH antagonist in the treatment of patients with polycystic ovary syndrome undergoing IVF:a systematic review and meta analysis[J].Gynecol Endocrinol,2015,29(3):187-191.
[9]张四友,郑敏.促性腺激素释放激素激动剂替代绒毛膜促性腺激素诱导排卵预防卵巢过度剌激综合征的初步观察[J].中华医学杂志,2014,1(3):273-275.
[10]阳翎.多剂量促性腺激素释放激素拮抗剂在体外受精一胚胎移植促超排卵中的应用效果[J].中华医学杂志,2015,24(4):535.
[11]刁飞扬,王嫜,黄洁,等.拮抗剂方案中应用促性腺激素释放激素激动剂诱发卵母细胞成熟后不同黄体支持方案对妊娠结局的影响-一项提前终止的前瞻随机临床对照研究[J].生殖医学杂志,2013,22(10):797-801.
[12]肖劲松,陈双陨,张春莲.促性腺激素释放激素拮抗剂在体外受精-胚胎移植中有效性的系统性评价[J].中国循证医学杂志,2010,10(12):1432-1438.
[13]周灿权,庄广伦.卵巢对超促排治疗的反应过度与不足[J].生殖医学杂志,2014,7(4):218.
[14]陈霞,赵军招,王佩玉,等.不同剂量hCG对体外受精-胚胎移植结局的影响[J].温州医学院学报,2015,42(2):154-156.
[15]Onofriescu A,Bors A,Luca A,et al.GnRH Antagonist IVF Protocol in PCOS[J].Curr Health Sci J,2015,39(1):20-25.
[16]Pundir J,Sunkara SK,El-Toukhy T,et al.Meta-analysis of GnRHantagonist protocols:do they reduce the risk of OHSS in PCOS[J].Reprod Biomed Online,2015,24(1):6-22.
[17]Gardner DK,Weissman A,Howles CM,et al.Textbook of assisted reproduetive technologies(laboratory and clinical perspectives),third edition[M].UK:Informa Press,2015:761.