克罗米芬诱导多囊卵巢综合征排卵失败的相关因素分析

摘要

目的探讨克罗米芬(CC)诱导多囊卵巢综合征(PCOS)排卵失败的相关因素。方法通过回顾分析178例569个周期的排卵率(OR)、排卵周期率(OCR)与临床特征及内分泌指标的关系。结果显示本组OR 73.0%，OCR 45.3%，功血、无排卵月经型OCR明显高于继发性闭经型(P＜0.005，0.05)，功血型明显高于月经稀发型(P＜0.05)；无多毛、非肥胖者OR显著高于多毛和肥胖者(P＜0.01，0.005)。未婚妇女OCR高于不孕和已育者(P＜0.025，0.005)。LH/FSH≥3、T正常者OCR分别高于LH/FSH＜3和T升高者，PRL正常者OR高于PRL升高者(P＜0.05～0.025)。LH/FSH、T、BMI与OR、OCR及PRL与OR有明显相关性(P＜0.05～0.01)。提示CC诱导PCOS排卵疗效与月经类型、多毛、肥胖、婚育状态、LH/FSH、T、PRL有关。%Objective　To explore the correlative factors of ovulation-failure induced with clomiphene(CC) in polycystic ovary syndrome(PCOS).Methods　The relationship between ovulation rate(OR),ovulation cycle rate(OCR) among 178 cases,569 taking medicine cycles and clinical features,endocrine markers were retrospectively analysed.Results　OR was 73.0%,OCR was 45.3%,OCR of both the dysfunctional uterine bleeding(DUB) and anovulatory menstruation groups were markedly higher than those of secondary amenorrhea group(P＜0.005，0.05)，OCR of the DUB group was significantly higher than that in oligomenstruation group too(P＜0.05).OR of the nonpilosity and nonobesity groups were markedly higher than that of pilosity and obesity groups respectively(P＜0.01，0.005).OCR of the unmarried group was significantly higher than infertility and fertilized groups(P＜0.025，0.005).OCR of LH/FSH≥3 and serum testosterone(T) level-normal groups were respectively higher than LH/FSH＜3 and serum T level-elevated group(P＜0.05～0.025).There was markedly correlation among LH/FSH radio,T level,BMI and OR,OCR,PRL levels and OR(P＜0.05～0.01).Conclusions　The findings suggest that effect of the ovulation induced with CC in PCOS relate to types of menstruation,pilosity,status of marry-fertility,levels of LH/FSH,T,PRL.