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多囊卵巢综合征伴高催乳素血症不孕患者50例临床观察
引用本文:徐彩生,郑丽璇,李素洁.多囊卵巢综合征伴高催乳素血症不孕患者50例临床观察[J].中国基层医药,2009,16(2):215-216.
作者姓名:徐彩生  郑丽璇  李素洁
作者单位:汕头大学医学院第一附属医院妇产科,广东省汕头,515041
摘    要:目的探讨多囊卵巢综合征伴高催乳素血症不孕患者的药物治疗方案、临床疗效及安全性。方法50例多囊卵巢综合征伴高催乳素血症不孕患者,根据溴隐亭使用的方案不同分为两组,Ⅰ组38例,溴隐亭治疗初始量为5mg/d,使催乳素水平维持正常后逐渐减少量,至维持量为每天1.25—2.5mg,治疗3周后,于月经第3—5天加用克罗米芬促排卵,B超监测卵泡生长,若无优势卵泡生长加用尿促激素(HMG)75U/L,直至卵泡直径达18mm时,改用人绒毛膜促性腺激素(HCG)5000—10000IU,HCG用药第2天及第3天指导同房或行人工授精;Ⅱ组12例,溴隐亭初始量同Ⅰ组,并在开始溴隐亭治疗的同时进行促排卵药物治疗,用法同Ⅰ组。观察两组促排卵药使用量及临床治疗效果。结果Ⅰ组HMG使用天数(指导同房、人工授精)分别为:(7.0±2.0)d、(8.0±1.0)d,与Ⅱ组的(12.0±2.0)d、(13.0±2.0)d相比较,差异均有统计学意义(均P〈0.05);Ⅰ组妊娠率为42.1%(16/38)高于Ⅱ组的25.0%(3/12)(P〈0.05)。结论多囊卵巢综合征伴高催乳素血症不孕患者,采用溴隐亭规范治疗,配合促排卵药物的使用,可以减少促排卵药物使用时间,提高临床妊娠率。

关 键 词:多囊卵巢综合征  高催乳素血症  不育  女性  溴隐亭

Analysis of therapeutic outcomes of polycystic ovary syndrome patients with hyperprolactinemia
XU Cai-sheng,ZHENG Li-xuan,LI Su-jie.Analysis of therapeutic outcomes of polycystic ovary syndrome patients with hyperprolactinemia[J].Chinese Journal of Primary Medicine and Pharmacy,2009,16(2):215-216.
Authors:XU Cai-sheng  ZHENG Li-xuan  LI Su-jie
Institution:( Department of Obstetrics and Gynecology, The First Affiliated Hospital of Shantou University Medical College ,Shantou, Guangdong 515041, China)
Abstract:Objective To study effect of drug treatment in polycystic ovary syndrome patients with hyperprolactinemia.Methods We retrospectively studied 50 women with polycystic ovary syndrome and hyperprolactinemia from the outpatient between January 2005 and April 2008.Acccording to the beginning time of bmmocriptine.all women were divided into two groups.Groups Ⅰ was composed of 38 cases who received bromocriptine before induction of ovulation cycies,and the dose of bromocriptine was modulated depending on the level of serum prolaotin.When serum prolactin was controlled at normal levels,we decreased the dosage of bromocriptine step by step(1.25mg once),and then continued the treatment at maintenance dosage for no less than 3 weeks.After a baseline ultrasonographic examination on day 3,patients were treated with clomiphene citrate at a dosage of 100mg(2 tablets/day)for 5 days of a normal cycle or progesterone-induced bleeding.On day 9.we monitored the growth conditions of follicles routinely with trails-vagihal ultrasound.If there was no dominant follicle,we added human menopausal hormone(HMG 75U/d)to the protocol.Human chorionic gonadotropin(HCG,5 000-10 000IU)was given intramuscularly when the mean diameter of a follicle reached at least 18mm.At the same time we iustmcted the patients to have sexual intercourses or carried out artificial inseminations before and after ovulation.Group Ⅱ were 12 cases in which induction of ovulations were commenced almost simultaneously with beginning of bromeoriptine.The same protucol was given to patients in group Ⅱ.The procedures of ovulation induction and the outcomes of treatment were analyzed and compared.Results Compared with groupⅡ.the days of using HMG in group Ⅰ was shorter by instructing the time of sexual intercourse.The difference was significant(P=0.004).And there were similar rosults in the artificial insemination cycles(P=0.009).The rate of pregnancy in group Ⅰ(42% 16/38)was higher than that in group Ⅱ(25%,3/12),but the difference was not obvious.Conclusion Bromocriptine administration before the stimulated ovulation therapy can decrease the total dosage and treatment course of ovulating drugs.Induction of ovulations simultaneously with start of bromocriptine therapy can shorten the treatment time of infertility.
Keywords:Polycystic ovary syndrome  Hyperprolaotinemia  Infertility  female  Bromocriptine
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