定经汤加味联合克罗米芬治疗肝郁肾虚型排卵障碍性不孕症患者临床观察

目的探讨定经汤加味联合克罗米芬治疗肝郁肾虚型排卵障碍性不孕症患者的临床效果。方法选取2016年5月至2017年5月我院收治的肝郁肾虚型排卵障碍性不孕症患者80例作为研究对象,采用随机数字表法分为对照组与观察组,每组40例。对照组患者单纯给予克罗米芬治疗,观察组患者给予定经汤加味联合克罗米芬治疗。比较两组患者的治疗效果,检测比较两组患者的子宫内膜厚度、卵泡直径以及排卵和妊娠情况,检测比较两组患者的卵泡刺激素(FSH)、雌二醇(E2)及促黄体生成素(LH)水平。结果治疗3个疗程后,观察组患者的临床疗效显著优于对照组,差异有统计学意义(P 0. 05);观察组患者的子宫内膜厚度、卵泡直径及妊娠率均显著大(高)于对照组,差异有统计学意义(P 0. 05);两组患者的FSH、E2水平均显著提高,LH水平均显著降低,观察组患者的FSH、E2水平显著高于对照组,LH水平显著低于对照组,差异有统计学意义(P 0. 05)。结论定经汤加味联合克罗米芬治疗排卵障碍性肝郁肾虚型排卵障碍性不孕症患者,可有效地增加患者子宫内膜厚度,促进胚胎着床,提高妊娠率,改善患者内分泌和免疫调节功能,提高临床治疗效果。     

重组人促卵泡激素治疗对多囊卵巢综合征患者血清激素水平、排卵及妊娠的影响

目的探讨重组人促卵泡激素(rhFSH)治疗对多囊卵巢综合征(PCOS)患者血清激素水平、排卵及妊娠率的影响。方法选择2017年6月至2018年5月在我院治疗的PCOS患者104例为研究对象,采用随机数字法分为两组,每组52例。对照组患者给予氯米芬治疗,观察组患者在对照组患者治疗的基础上加用rhFSH治疗,疗程10 d。比较两组患者的临床疗效、血清激素水平、宫颈黏液评分、子宫内膜厚度、排卵率、妊娠率及不良反应发生情况。结果治疗结束后随访12个月,观察组患者的治疗总有效率(90.38%)明显高于对照组(73.08%),差异有统计学意义(P0.05)。治疗月经周期第21天时,两组患者的卵泡刺激素(FSH)、孕酮(P)、雌二醇(E2)水平均明显升高,观察组患者的水平显著高于对照组,差异有统计学意义(P0.05)。治疗10 d后,两组患者的宫颈黏液评分明显增高、子宫内膜明显增厚,观察组患者的评分显著高于对照组,子宫内膜厚度显著大于对照组,差异有统计学意义(P0.05)。观察组患者治疗月经周期的排卵率(65.38%)明显高于对照组(36.54%);随访12个月,观察组患者的妊娠率(30.77%)明显高于对照组(13.46%),差异有统计学意义(P0.05)。治疗期间,两组患者的不良反应发生率比较差异无统计学意义(P0.05)。结论重组人促卵泡激素治疗有利于改善多囊卵巢综合征患者的血清激素水平,促进患者排卵,提高患者的妊娠率,治疗安全性高。     

破泡授精术治疗促卵后排卵障碍性不孕症

目的　探讨破泡授精术治疗促卵后排卵障碍性不孕症的可行性。方法　选择 2 80例促卵后排卵障碍性不孕症患者 ,随机分为两组。卵泡穿刺组 136例 ,在阴道超声指引下行卵泡穿刺协助其排卵 ,同时行人工授精术 ;对照组 14 4例 ,直接行人工授精术。结果　卵泡穿刺组临床妊娠率 4 6 .32 % ,卵巢过度刺激综合征 (OHSS)发生率 9.5 6 % ;对照组临床妊娠率 18.75 % ,OHSS发生率 2 9.86 %。两组相比 ,P均 <0 .0 1。结论　破泡授精术治疗促卵后排卵障碍性不孕症是可行的 ,临床妊娠率高 ,OHSS发生率低     

腹腔镜下卵巢打孔术治疗多囊卵巢综合征合并不孕的临床效果观察

目的探讨采用腹腔镜下卵巢打孔术治疗多囊卵巢综合征(PCOS)合并不孕的疗效。方法选取2012-03~2014-03该院妇产科收治的64例PCOS合并不孕患者,根据治疗方式不同分为对照组和观察组,每组32例,分别给予B超下经阴道卵泡穿刺术治疗和腹腔镜下卵巢打孔术治疗,观察两组疗效。结果两组黄体生成素(LH)、LH/卵泡刺激素(FSH)、睾酮(T)与治疗前比较均显著下降(P0.05),而观察组下降更为明显(P0.05);与治疗前比较,两组FSH稍上升,雌二醇(E2)稍下降(P0.05);观察组术后妊娠率、自然排卵率较对照组明显升高(P0.05),而流产率较对照组明显降低(P0.05)。结论 PCOS合并不孕患者采取腹腔镜下卵巢打孔术治疗,临床疗效显著,妊娠率高,具有推广价值。     

炔雌醇环丙孕酮片联合二甲双胍治疗对多囊卵巢综合征患者性激素及血清内脂素的影响

目的探讨炔雌醇环丙孕酮片联合二甲双胍治疗对多囊卵巢综合征患者性激素及血清内脂素水平的影响。方法选择2018年3月至2019年4月我院收治的多囊卵巢综合征患者46例,采用随机数字表法分为对照组和观察组,每组23例。对照组患者在月经周期最后1天口服炔雌醇环丙孕酮片治疗,连续服用21 d后停止,至下个月经周期最后1天继续按上述方法服药。观察组患者在对照组治疗的基础上加用二甲双胍肠溶片治疗,用法同炔雌醇环丙孕酮片。两组患者均连续治疗3个月经周期。检测比较两组患者治疗前后的血清促卵泡激素(FSH)、促黄体素(LH)、雌二醇(E_2)、睾酮(T)、血清内脂素水平及不良反应发生情况。结果治疗3个月经周期后,观察组患者的FSH水平显著降低,两组患者的LH、T、E_2水平均显著降低;观察组患者的FSH、LH、T水平显著低于对照组,E_2水平高于对照组,差异有统计学意义(P0.05);两组患者的血清内脂素水平均显著降低,观察组患者的水平显著低于对照组,差异有统计学意义(P0.05)。治疗过程中,观察组患者头痛、血压升高等不良反应的总发生率略低于对照组,但差异无统计学意义(P0.05)。结论炔雌醇环丙孕酮片联合二甲双胍肠溶片治疗可有改善多囊卵巢综合征患者的性激素分泌状况,降低血清内脂素水平,改善患者卵巢功能促进正常排卵,但不会增加不良反应的发生。     

GnRHa、HCG诱导卵泡成熟在来曲唑联合HMG促排卵治疗PCOS不孕中的应用

目的比较促性腺激素释放激素激动剂(GnRHa)、绒毛膜促性腺激素(HCG)诱导卵泡成熟在来曲唑联合HMG促排卵治疗多囊卵巢综合征(PCOS)不孕中的应用效果。方法 60例PCOS不孕患者随机分为GnRHa组和HCG组各30例。所有患者均采用来曲唑联合HMG促排卵方案,当主导卵泡平均直径为18～20 mm时,GnRHa组采用GnRHa(达必佳)0.1 mg诱导卵泡成熟,HCG组采用HCG 10 000 U诱导卵泡成熟。比较两组的排卵率、临床妊娠率、早期流产和多胎妊娠、中重度卵巢过度刺激综合征(OHSS)、卵泡未破裂黄素化综合征(LUFS)的发生情况。结果 GnRHa组与HCG组排卵率、临床妊娠率、早期流产和多胎妊娠、中重度OHSS、LUFS的发生例数比较,P均>0.05。两组轻度OHSS发生例数相比,P<0.05。结论用来曲唑联合HMG促排卵方案治疗PCOS不孕时,可用GnRHa替代HCG诱导卵泡成熟,同时适当补充黄体酮可增强黄体功能而不影响临床妊娠率。     

克罗米芬联合二甲双胍治疗多囊卵巢综合征的临床疗效研究

目的观察克罗米芬联合二甲双胍治疗多囊卵巢综合征(PCOS)的临床疗效。方法选取2015—2016年在湖北省中西医结合医院妇科门诊治疗的PCOS患者80例,随机分为对照组和治疗组,各40例。对照组患者单纯给予克罗米芬治疗,治疗组患者在对照组基础上加用二甲双胍,均连续治疗3个月经周期。比较两组患者治疗后内分泌激素指标、临床疗效、排卵及妊娠情况。结果治疗后治疗组睾酮(T)、雌二醇(E2)、黄体生成素(LH)、促卵泡激素(FSH)水平低于对照组(P0.01);治疗组患者总有效率和妊娠率高于对照组(P0.05);治疗后治疗组患者妊娠率高于对照组(P0.05);两组患者排卵率和早孕流产率比较,差异无统计学意义(P0.05)。结论克罗米芬联合二甲双胍治疗PCOS的临床疗效确切,能有效改善患者内分泌激素水平,提高妊娠率。     

中医辨证治疗排卵障碍性不孕疗效初步观察及评估

目的探讨中医辨证治疗排卵障碍性不孕的治疗疗效。方法选取我院2012年3月~2015年7月收治的排卵障碍性不孕患者120例作为研究对象,按照随机数字法分为对照组与观察组,各60例。其中对照组采用西药进行治疗,而观察组采用中医辩证治疗,比较两种方式的治疗疗效。结果观察组排卵率及受孕率分别为90.00%、86.67%,明显优于对照组,差异有统计学意义(P0.05)。结论中医辨证治疗排卵障碍性不孕具有显著的疗效,可有效提高患者的排卵率及受孕率,值得推广及运用。     

经阴道小卵泡穿刺抽吸术治疗多囊卵巢综合征临床研究

将66例行人绝经期促性腺激素（hMG）促排卵的多囊卵巢综合征（PCOS）不孕患者随机分成两组,观察组于卵泡直径达9～10 mm时经阴道行卵泡穿刺抽吸术,对照组仅行常规促排卵,连续观察6个月。手术前后检测血黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）、雌二醇（E2）、泌乳素（PRL）水平,排卵情况,妊娠率及妊娠结局。结果观察组术后排卵率、妊娠率均明显高于对照组（P〈0.01）;T、E2、PRL水平无明显变化,LH、LH/FSH、T值均较术前降低,FSH值明显升高（P〈0.01）;未见卵巢过度刺激综合征发生。认为卵泡期经阴道小卵泡穿刺抽吸术治疗PCOS损伤小,并发症少,术后排卵率及妊娠率高,是PCOS有效的治疗途径。     

二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征患者的疗效以及对卵巢功能、妊娠率的影响

目的探讨二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征患者的临床效果以及对卵巢功能、妊娠率的影响。方法选择2016年3月至2018年3月在本院接受治疗的多囊卵巢综合征患者86例为研究对象,采用随机数字表法分为观察组和对照组,每组43例。对照组患者给予炔雌醇环丙孕酮片治疗,观察组患者在对照组治疗的基础上给予二甲双胍治疗。两组患者均治疗3个疗程(3个月经周期)。比较两组患者的临床疗效;比较两组患者治疗前后的卵巢功能;随访1年,比较两组患者的妊娠情况。结果观察组患者的治疗总有效率(97.67%)显著高于对照组(81.40%),差异有统计学意义(P0.05)。治疗前,两组患者的促黄体生成素(LH)、促卵泡生成素(FSH)、睾酮(T)、雌二醇(E_2)水平比较,差异无统计学意义(P0.05)。治疗3个疗程后,两组患者的LH、FSH、T水平均显著降低,观察组患者的水平显著低于对照组;两组患者E_2水平均较显著升高,观察组患者的水平显著高于对照组,差异有统计学意义(P0.05)。随访1年,观察组患者的妊娠率(93.02%)显著高于对照组(72.09%),差异有统计学意义(P0.05)。结论二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征患者的临床效果显著,能够有效改善患者卵巢功能,显著提高妊娠率。     

Follicular phase dynamics with combined aromatase inhibitor and follicle stimulating hormone treatment

OBJECTIVE: The objective of this study was to evaluate follicular phase parameters during ovarian stimulation with FSH alone or with the aromatase inhibitor letrozole. METHODS: Two groups of women undergoing intrauterine insemination (IUI): group I (389 patients; mean age 35 +/- 4.3 yr) underwent 630 IUI cycles stimulated with letrozole and FSH; and group II (134 patients; mean age 36.0 +/- 4.6 yr) underwent 166 IUI cycles stimulated with FSH only. Each group was stratified into ovulatory and anovulatory cycles. Patients were monitored by ultrasound for folliculometry and blood sampling for hormonal assay on d 3, 7, 9, or 10 of the cycle, and on the day of human chorionic gonadotropin administration. RESULTS: Group I had a significantly lower follicular count greater than 10 mm on d 7, greater than 12 mm on d 9 or 10, and greater than 15 mm on the day of human chorionic gonadotropin administration compared to group II (P = 0.006, <0.001, and <0.001, respectively). After stratifying patients by diagnosis, this relationship was maintained only for patients with ovulatory infertility (P = 0.003, <0.001, and <0.001, respectively). Serum estradiol (E2) was significantly lower in the group I ovulatory and anovulatory at the last three monitoring visits (P < 0.001). However, the difference in E2 levels decreased in the preovulatory period with similar E2 levels per mature follicle. No premature preovulatory progesterone rise was observed in either group. However, significantly lower progesterone levels were observed in the second half of the follicular phase in group I (P = 0.02 and <0.001). Endometrial thickness was significantly lower in group I at the second and third visits (P < 0.001, 0.01) but was comparable to group II at the last monitoring visit. Although, the pregnancy rates were similar between the two groups, the multiple pregnancy rate was significantly higher in the FSH-only group (P = 0.039). CONCLUSION: The addition of letrozole modifies the follicular, hormonal, and endometrial dynamics of FSH-stimulated cycles with possible positive effects on the overall cycle outcome.     

彩色多普勒检测卵巢动脉的临床价值

目的探讨卵巢动脉血流对卵泡成熟的影响及临床不孕症的诊断意义。方法采取经阴道彩色多普勒 (Transvaginal color Doppler imaging,TVCD)观测10例正常育龄妇女和10例不孕妇女的排卵声像及卵巢动脉血流彩色图像予以对比分析。结果正常妇女卵巢动脉血流与卵泡发育呈正相关系,排卵前卵泡直径增至最大,此时卵巢动脉血流速度呈现高峰,排卵过程显像可见。不孕妇女卵巢动脉舒张期血流呈持续低振幅高阻抗,卵泡发育参差不一,直径最小<13mm,最大>28mm不等,不见排卵迹象,两组比较差异有显著性意义(P<0．05)。结论 TVCD检测卵巢动脉不仅了解卵泡成熟情况而且可准确测定排卵日期,有助于不孕症的诊断与治疗。     

二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗不孕患者疗效观察

目的 探讨二甲双胍(MTF)治疗多囊卵巢综合征(PCOS)合并胰岛素抵抗(IR)不孕患者的效果.方法 42例PCOS合并IR不孕患者,其中22例作为试验组,口服MTF,3月未妊娠者加服克罗米芬(CC)3个周期;另20例直接口服CC 3个周期作为对照组,观察两组排卵情况、妊娠结局及睾酮(T)、空腹胰岛素(INS)、体重指数(BMI)、血脂等指标的变化.结果 试验组有14例(64%)恢复排卵;其中11例(50%)妊娠,均未发生流产,用药3个月后T、INS、BMI均明显降低(P<0.05),血脂变化不明显(P>0.05).对照组有13例(65%)恢复排卵;其中6例(30%)妊娠,均未发生流产;用药3个月后BMI、INS、T、血脂均无明显降低(P>0.05).结论 应用MTF治疗可提高IR患者的妊娠率及降低T、INS、BMI,且安全、经济、方便.     

Specific factors predict the response to pulsatile gonadotropin-releasing hormone therapy in polycystic ovarian syndrome

Ovulation induction is particularly challenging in patients with polycystic ovarian syndrome (PCOS) and may be complicated by multifollicular development. Pulsatile GnRH stimulates monofollicular development in women with anovulatory infertility; however, ovulation rates are considerably lower in the subgroup of patients with PCOS. The aim of this retrospective study was to determine specific hormonal, metabolic, and ovarian morphological characteristics that predict an ovulatory response to pulsatile GnRH therapy in patients with PCOS. Subjects with PCOS were defined by chronic amenorrhea or oligomenorrhea and clinical and/or biochemical hyperandrogenism in the absence of an adrenal or pituitary disorder. At baseline, gonadotropin dynamics were assessed by 10-min blood sampling, insulin resistance by fasting insulin levels, ovarian morphology by transvaginal ultrasound, and androgen production by total testosterone levels. Intravenous pulsatile GnRH was then administered. During GnRH stimulation, daily blood samples were analyzed for gonadotropins, estradiol (E(2)), progesterone, inhibin B, and androgen levels, and serial ultrasounds were performed. Forty-one women with PCOS underwent a total of 144 ovulation induction cycles with pulsatile GnRH. Fifty-six percent of patients ovulated with 40% of ovulatory patients achieving pregnancy. Among the baseline characteristics, ovulatory cycles were associated with lower body mass index (P < 0.05), lower fasting insulin (P = 0.02), lower 17-hydroxyprogesterone and testosterone responses to hCG (P < 0.03) and higher FSH (P < 0.05). In the first week of pulsatile GnRH treatment, E(2) and the size of the largest follicle were higher (P < 0.03), whereas androstenedione was lower (P < 0.01) in ovulatory compared with anovulatory patients. Estradiol levels of 230 pg/mL (844 pmol/L) or more and androstenedione levels of 2.5 ng/mL (8.7 nmol/L) or less on day 4 and follicle diameter of 11 mm or more by day 7 of pulsatile GnRH treatment had positive predictive values for ovulation of 86.4%, 88.4%, and 99.6%, respectively. Ovulatory patients who conceived had lower free testosterone levels at baseline (P < 0.04). In conclusion, pulsatile GnRH is an effective and safe method of ovulation induction in a subset of patients with PCOS. Patient characteristics associated with successful ovulation in response to pulsatile GnRH include lower body mass index and fasting insulin levels, lower androgen response to hCG, and higher baseline FSH. In ovulatory patients, high free testosterone is negatively associated with pregnancy. A trial of pulsatile GnRH therapy may be useful in all PCOS patients, as E(2) and androstenedione levels on day 4 or follicle diameter on day 7 of therapy are highly predictive of the ovulatory response in this group of patients.     

不同不育类型患者精液质量比较及对补救卵胞浆内单精子注射术临床结局的影响分析

目的 探讨不同不育类型患者精液质量情况及其对补救卵胞浆内单精子注射术(R-ICSI)临床结局的影响.方法 回顾性研究2014-01～2018-12于广西壮族自治区人民医院生殖医学与遗传中心行常规体外受精-胚胎移植(IVF-ET)失败而进行R-ICSI治疗的98对不孕不育夫妇的临床资料.根据不育类型将98对夫妇分为原发性...     

OVULATORY DISTURBANCES IN PATIENTS WITH LUTEAL INSUFFICIENCY

In order to study ovulatory disturbances in patients with luteal insufficiency we evaluated 210 cycles of 170 women from infertile couples by ultrasonographic follicle measurements and hormonal determinations. Only cycles with evidence of luteinization were included into the study. Mid-luteal progesterone (P) levels were determined in relation to the ultrasonographic ovulation time or, where the follicle failed to rupture, in relation to the LH peak. In spontaneous cycles with a mid-luteal P level below 32 nmol/l (10 ng/ml) a luteinized unruptured follicle (LUF) was found in 71.1% of cycles, whereas in spontaneous cycles with a mid-luteal P level above 32 nmol/l only 7.9% cycles exhibited a failure of the follicle to rupture. The same phenomenon was encountered in cycles in which agents had been given to induce ovulation. The incidence of LUF cycles in an average infertility population could be calculated to be as high as 50% if the mid-luteal P level is below 32 nmol/l and as low as 4% if the mid-luteal P level is above 32 nmol/l. The geometric mean mid-luteal P level in spontaneous LUF cycles was 32.5 nmol/l, compared to 55.2 nmol/l in spontaneous ovulatory cycles (P less than 0.001). We conclude that in patients with luteal insufficiency a high incidence is found of a failure of the follicle to rupture. The entrapment of the oocyte in the unruptured follicle constitutes an important cause of infertility in these patients.     

去乙酰毛花苷注射液联合酒石酸美托洛尔治疗急性左心衰伴快速心室率心房颤动患者的效果分析

目的研究去乙酰毛花苷注射液联合酒石酸美托洛尔治疗急性左心衰伴快速心室率心房颤动的效果。 方法选取2016年5月至2017年3月胶州市人民医院收治的74例急性左心衰伴快速心室率心房颤动患者,依照治疗方案分为观察组和对照组,各37例。在常规治疗基础上,对照组接受去乙酰毛花苷注射液治疗,观察组接受去乙酰毛花苷注射液＋酒石酸美托洛尔治疗。比较两组疗效,治疗前后心室率、QT间期、心功能指标[心排血量(CO)、左心室射血分数(LVEF)]。 结果观察组治疗有效率94.59%(35/37)高于对照组72.97%(27/37),差异有统计学意义(P<0.05)。治疗后两组QT间期对比,差异无统计学意义(P>0.05),观察组心室率低于对照组(P<0.05)。治疗后观察组LVEF、CO高于对照组(P<0.05)。 结论去乙酰毛花苷注射液联合酒石酸美托洛尔治疗急性左心衰伴快速心室率心房颤动效果显著,能有效恢复患者心室率,改善心功能。     

妊娠期糖尿病患者不同孕周接受胰岛素治疗对于妊娠结局的影响

目的探讨妊娠期糖尿病患者不同孕周接受胰岛素治疗对于妊娠结局的影响。方法2019年1月—2020年2月间选取妊娠期糖尿病患者80例,根据胰岛素首次治疗的孕周,其中38例患者胰岛素首次治疗时的孕周>32周(对照组),42例患者胰岛素首次治疗时的孕周≤32周(观察组),比较两组血糖水平、妊娠结局与新生儿结局。结果与治疗前比较,两组治疗后空腹血糖(FPG)与餐后2 h血糖(2 hPG)水平均更低(P<0.05);与对照组比较,观察组治疗后FPG[(5.92±1.08)mmol/L vs(5.19±0.76)mmol/L]与2 hPG[(9.36±1.25)mmol/L vs(7.60±0.88)mmol/L]水平均更低,差异有统计学意义(P<0.05);两组剖宫产率(31.58%vs 30.95%)差异无统计学意义(P>0.05);与对照组比较,观察组羊水过多(30.00%vs 4.76%)、妊娠期高血压(47.37%vs 23.81%)与产后出血(30.00%vs 4.76%)发生率均更低,差异有统计学意义(P<0.05),早产(5.26%vs 21.43%)发生率更高,差异有统计学意义(P<0.05);与对照组比较,观察组新生儿窒息(21.05%vs 2.38%)、高胆红素血症(21.05%vs 4.76%)、低血糖(21.05%vs 2.38%)与低体重儿(21.05%vs 2.38%)发生率更低,差异有统计学意义(P<0.05)。结论妊娠期糖尿病患者在妊娠32周前接受胰岛素治疗,可使机体血糖得到更为有效控制,促使妊娠结局改善。     

The assessment of ovulation by a combination of ultrasound and detailed serial hormone profiles in 35 women with long-standing unexplained infertility

We have examined for the presence of subtle hormonal abnormalities in women with long-standing unexplained infertility. For a full cycle serum LH, FSH, progesterone and oestradiol levels were measured about three times a week, and serial ultrasound scans of the ovaries made until the time of apparent ovulation. The results on 45 cycles in 35 women with unexplained infertility and in three normal volunteers are presented. Normal ovulatory cycles were defined by a length of 26-32 d, and progressive follicular maturation followed by disappearance or abrupt reduction in size of a follicle within 48 h of the recorded LH peak, followed by progressive and sustained rise in serum progesterone levels to more than 25 nmol/l and a luteal phase length of greater than or equal to 13 d. Thirty spontaneous cycles (28 women) were clearly normal while 15 spontaneous cycles (12 women) were abnormal. Abnormalities included luteinization of an unruptured follicle (eight cycles), absence of follicular development (two cycles), poor follicular development (two cycles), persistence of a large ovarian cyst from the preceeding cycle (two cycles) and one aluteal cycle. Six of the abnormal cycles were characterized hormonally by inappropriate elevation of serum LH levels throughout. If this study had been based only on serial ultrasound scans, all results on abnormal cycles might have been misinterpreted. If it had been conducted only with (multiple) progesterone determinations and the level of greater than 25 nmol/l had been taken as indicative of ovulation nine clearly abnormal cycles would have been considered as normal. We conclude that the combination of the hormonal and ultrasound assessment of ovulation increases our confidence for confirmation of normality and reveals various ovulatory disorders which are possibly due to an endocrinological defect or defects.     

口服降糖药物在妊娠糖尿病治疗中的临床应用及对控制血糖水平的作用分析

目的妊娠糖尿病74例患者,治疗统计,讨论口服降糖药物的效果。方法2019年5—9月搜集患者库妊娠糖尿病患者并选出74例分两组(随机数表法),对照组皮下注射胰岛素,观察组在上述基础上口服二甲双胍。比较两组血糖、母婴结局。结果病情对比血糖,两组治疗前FPG、2 hPG、NPG水平差异无统计学意义(P>0.05);观察组治疗后FPG、2 hPG、NPG水平相对于对照组均较低,差异有统计学意义(P<0.05);效果对比母婴结局,观察组不良妊娠结局发生率相对于对照组较低(5.41%vs 21.62%),差异有统计学意义(P<0.05);观察组产妇Barthel指数、新生儿出生时、出生5 min时Apgar评分相对于对照组均较高,差异有统计学意义(P<0.05)。结论口服降糖药物二甲双胍可改善妊娠糖尿病患者血糖控制情况,降低血糖水平,改善妊娠结局。