来曲唑对多囊卵巢综合征患者性激素结合球蛋白水平及糖脂代谢指标的影响

目的探究来曲唑(LE)对多囊卵巢综合征(PCOS)患者性激素结合球蛋白(SHBG)水平及糖脂代谢指标的影响。方法选取2016年6月至2019年6月本院诊治的80例PCOS患者为研究对象。根据非随机临床同期对照研究及患者自愿原则分为观察组、对照组,每组40例,对照组患者口服枸橼酸氯米芬片(初始剂量50 mg/d,无排卵反应后增至100mg/d)治疗,观察组给予LE(月经第5天口服LE,5 mg/d)治疗,两组均持续给药5 d,比较治疗前、疗程结束后两组糖脂代谢指标[总胆固醇(TC)、低密度脂蛋白(LDLC)、三酰甘油(TG)及空腹胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)]、SHBG水平、性激素[卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)]水平、排卵、妊娠情况及药物安全性。结果与同组治疗前比较,疗程结束后两组TC、LDLC、TG、INS、HOMA-IR明显降低(P<0.05),且观察组INS、HOMA-IR明显低于对照组(P<0.05),与同组治疗前比较,疗程结束后两组SHBG、FSH明显升高、LH、E2、T明显降低,且观察组SHBG、FSH相较于对照组显著升高、LH、E2、T显著降低(P<0.05),观察组周期排卵率、临床妊娠率明显高于对照组(χ^2=4.228、4.073,P<0.05),观察组不良反应总发生率与对照组比较差异无统计学意义(P>0.05)。结论LE治疗PCOS患者的促排卵效果显著,可明显降低SHBG水平、调节性激素水平并提高临床妊娠率,而促排卵治疗前需指导应用抗雄激素药物、胰岛素增敏剂以有效调节患者的糖脂代谢指标。     

补肾逐瘀汤联合来曲唑治疗输卵管炎性阻塞性不孕症的疗效观察

目的 探讨补肾逐瘀汤联合来曲唑治疗输卵管炎性阻塞性不孕症的疗效。方法 选取2017年1月-2019年1月在该院接受治疗的输卵管炎性阻塞性不孕症患者80例为研究对象,根据随机数表法分为观察组和对照组,每组各40例。对照组采用来曲唑片治疗,观察组在对照租基础上采用补肾逐瘀汤治疗。治疗3个月后,比较两组患者治疗效果、中医证候积分、局部体征积分、白介素细胞-6(IL-6)、肿瘤坏死因子(TNF-α)及不良反应;治疗后随访6个月,记录两组自然受孕率、输卵管再通率和流产率。结果 观察组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者中医证候积分、局部体征积分、炎症因子水平均低治疗前低,且观察组患者腹痛、腰骶酸痛、带下异常评分、局部体征积分、IL-6及TNF-α水平均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者自然受孕率及输卵管再通率均高于对照组,流产率低于对照组,差异均有统计学意义(均P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 输卵管炎性阻塞性不孕症应用补肾逐瘀汤联合来曲唑治疗效果较好,可有效改善患者临床症状,减轻炎症反应,提高自然受孕率及输卵管再通率,且安全性较高。     

来曲唑和枸橼酸氯米芬诱导多囊卵巢综合征患者排卵疗效分析

目的评价多囊卵巢综合征患者使用来曲唑和枸橼酸氯米芬诱导排卵的有效性。方法全面检索相关的中英文数据库,提取数据资料,应用系统评价专用处理软件RevMan4．2进行人选研究的同质性检验和数据的合并分析。结果共5篇文献被纳入。来曲唑组和枸橼酸氯米芬组妊娠率比较相对危险度1．46（0．87～2．44）,P=0．15;排卵率相对危险度0．96（0．90～1．03）,P=0．22,均无显著性差异;对枸橼酸氯米芬抵抗和反应不良的多囊卵巢综合征患者使用来曲唑妊娠率更高,相对危险度2．12（1．14～3．97）,P=0．02,差异有显著性。来曲唑组注射绒毛膜促性腺素日雌二醇水平更低,差异有显著性（P=0．0003）。≥18mm卵泡数、注射绒毛膜促性腺素日子宫内膜厚度和流产率无显著性差异（P=0．43,P=0．43,P=0．66）。结论多囊卵巢综合征患者使用来曲唑和枸橼酸氯米芬诱导排卵的疗效没有显著差异,尚无充分证据证明来曲唑的疗效优于枸橼酸氯米芬,需要进行更多的临床研究。     

克罗米芬与来曲唑用于多囊卵巢综合征性不孕患者促排卵效果观察

目的 探讨克罗米芬(CC)与来曲唑(LE)用于多囊卵巢综合征(PCOS)性不孕症患者促排卵治疗的效果.方法 以75例PCOS不孕症患者为研究对象,分为CC组和LE组,分别纳入病例37例和38例,观察2组促排卵的临床效果.结果 CC组平均完成4.4个(162/37)周期,LE组平均完成5.2个(198/38)周期,CC组有排卵的周期(54.9%,89/162)明显多于LE组(42.4%,84/198),差异有统计学意义(P<0.05).CC组人绒毛膜促性腺激素(HCG)日子宫内膜厚度、成熟卵泡数和雌二醇(E2)激素水平与LE组比较差异有统计学意义(P<0.05).CC组随访妊娠率35.1%(13/37),LE组39.4%(15/38),差异无统计学意义(P>0.05).结论 克罗米芬用于PCOS患者促排卵,平均促排卵周期少,有排卵的周期比例高,HCG日成熟卵泡数多,但是影响子宫内膜厚度和E2激素水平,治疗后临床妊娠率与来曲唑相当.     

来曲唑联合地塞米松对多囊卵巢综合征患者血清Galectin-3及HSP70的影响

目的 探讨来曲唑联合地塞米松对多囊卵巢综合征(PCOS)患者血清半乳糖凝集素-3(Galectin-3)及热休克蛋白(HSP70)表达的影响。方法 选择2019年6月—2021年6月在我院治疗的PCOS患者220例为研究对象,按随机数表法分为对照组(n=110)和观察组(n=110),对照组常规给予来曲唑治疗。观察组在对照组的基础上加用地塞米松联合治疗。观察并比较两组患者的激素水平,促排卵情况,血清抗苗勒管激素(AMH)、Galectin-3、HSP70及单核细胞趋化蛋白-1(MCP-1)水平及不良反应发生率。结果 治疗后两组患者的性激素水平均改善,且观察组变化幅度高于对照组(P<0.05)。观察组患者雌二醇(E₂)用量低于对照组,成熟卵泡数量和最大卵泡直径均高于对照组(均P<0.05)。两组患者的早期流产率差异无统计学意义(P>0.05);观察组患者的妊娠率高于对照组(P<0.05)。治疗前两组患者AMH、Galectin-3、HSP70、MCP-1水平差异无统计学意义(P>0.05),治疗后两组患者的AMH、Galectin-3、...     

来曲唑联合拮抗剂方案在卵巢储备功能低下患者辅助生殖技术中的疗效观察

目的:观察来曲唑联合拮抗剂方案应用于卵巢储备功能低下患者体外受精（in vitro fertilization,IVF）助孕的疗效。方法:将2019年10月至2020年10月期间在东莞市妇幼保健院的波塞冬标准3、4组的卵巢储备功能低下的26例患者应用随机数字表法分为2组。来曲唑组年龄（35.69±4.25）岁,体质量指...     

Letrozole and Unexplained Infertility: A Contemporary Meta-analysis

The results of a meta-analysis comparing the efficacy of clomiphene versus letrozole among couples with unexplained infertility in 2014 are in contrast to those of a randomized trial in 2015. This new meta-analysis included randomized studies that were not previously included and found that the efficacy of clomiphene or letrozole in women with unexplained infertility is comparable (Canadian Task Force Classification I).     

Different patterns in the risk of newly developed fatty liver and lipid changes with tamoxifen versus aromatase inhibitors in postmenopausal women with early breast cancer: A propensity score–matched cohort study

BackgroundManagement of metabolic complications of long-term adjuvant endocrine therapy in early breast cancer remained an unmet need. We aimed to compare the effects of tamoxifen (TMX) and aromatase inhibitors (AIs) on the risk of fatty liver in conjunction with longitudinal changes in the serum lipid parameters.MethodsAmong 1203 subjects who were taking adjuvant TMX or AI (anastrozole or letrozole) without fatty liver at baseline, those taking TMX or AI were 1:1 matched on the propensity score. The primary outcome was newly developed fatty liver detected on annual liver ultrasonography.ResultsAmong 328 matched subjects (mean age 53.5 years, body mass index 22.9 kg/m²), 62 cases of fatty liver in the TMX group and 41 cases in the AI group were detected in a total of 987.4 person-years. The incidence rate of fatty liver was higher in the TMX group than in the AI group (128.7 versus 81.1 per 1000 person-years, P = 0.021), particularly within the first 2 years of therapy. TMX was associated with an increased 5-year risk of newly developed fatty liver (adjusted hazard ratio 1.61, P = 0.030) compared with AI independent of obesity and cholesterol level. Subjects who developed fatty liver had higher triglycerides (TGs) and lower high-density lipoprotein cholesterol (HDL-C) level at baseline than those without, which was sustained during follow-up despite the serum cholesterol–lowering effect of TMX.ConclusionsTMX independently increased the 5-year risk of newly developed fatty liver compared with AI in postmenopausal women with early breast cancer. Our findings suggest the need for considering the risk of fatty liver as a different adverse event profile between AI and TMX, particularly in patients with obesity, high TGs and low HDL-C.     

来曲唑片在健康男性受试者中的生物等效性研究

目的研究来曲唑片在健康男性受试者中的相对生物利用度,评价两种来曲唑片剂的生物等效性。方法26名男性健康志愿者随机交叉、单剂量口服试验制剂来曲唑片和参比制剂来曲唑片,剂量为2．5mg,用HPLC-MS／MS法检测来曲唑的血药浓度。利用DASVer2．0进行药动学参数计算和统计分析。结果试验制剂和参比制剂主要药代动力学参数c分别为（38．1±8．8）和（37．0±9．9）μg．L-1,tmax分别为（1．7±0．9）和（1．7±0．7）h,t/2分别为（66．2±40．3）和（63．6±44．5）h,AUC-分别为（2451．7±1121．7）和（2437．0±1342．2）gg．h-1．L-1,AUC分别为（2729．8±1660．3）和（2758．8±2065．0）μg．h-1．L-1。来曲唑片试验制剂相对于参比制剂的相对生物利用度F（以AUC作为评价依据）为：105．6％±19．4％。结论两种来曲唑片剂在健康人体中具有生物等效性。     

Development of a High-Performance Liquid Chromatographic Method for Determination of Letrozole in Wistar Rat Serum and its Application in Pharmacokinetic Studies

A fast, sensitive, and specific reversed-phase high-performance liquid chromatographic (RP–HPLC) method for the determination of letrozole in Wistar rat serum was developed. In this method, liquid–liquid extraction of letrozole was achieved using diethyl ether as the extracting solvent. The analysis was carried out on a reversed-phase C18 (250 mm × 4.6 mm, 5 μm) column with an isocratic mobile phase of methanol–water (70:30,v/v), at a flow rate of 1.0 mL min⁻¹. Detection was carried out at 239 nm with a UV–visible spectrophoto-metric detector. The method was shown to be selective and linear over the concentration range of 0.15–100 μg mL⁻¹. The intra-day and inter-day precision studies showed good reproducibility with coefficients of variation less than 11% for the analyte. The relative errors of intra– and inter–day accuracy were within −11.52 to −2.26%. The limit of quantification was evaluated to be 0.15 μg mL⁻¹. The method was successfully applied for the pharmacokinetic study of letrozole after oral administration of 10 mg kg⁻¹ of letrozole in six healthy Wistar rats.