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目的:探讨达因-35对不同类型多囊卵巢综合征(PCOS)血清激素及窦卵泡数等的影响。方法:将138例PCOS患者按鹿特丹标准进行分型,选择同期无高雄激素血症及月经紊乱的输卵管性不孕患者78例作为对照组。测定血清生殖激素及空腹胰岛素(FINS)等水平,盆腔超声检测卵巢体积及窦卵泡计数,经达因-35治疗3个周期后观察上述指标变化,评价达因-35对不同类型PCOS的治疗效果。结果:A型[无排卵(O/A)+高雄激素(HA)+卵巢多囊(PCO)]、B型(O/A+PCO)、C型(HA+O/A)和D型(HA+PCO)分别为43例、73例、15例和7例。A型、C型和D型总睾酮(TT)和硫酸脱氢表雄酮(DHEAS)水平高于对照组,各型LH、LH/FSH、FINS及胰岛素评价指数(HOMA-IR)高于对照组,差异均有统计学意义(P<0.05)。A型、B型和D型窦卵泡数多于C型及对照组,差异有统计学意义(P<0.05)。达因-35治疗3个周期后:A型、C型和D型血清TT降低,差异有统计学意义(P<0.05);DHEAS水平有所降低,但差异无统计学意义(P>0.05);各型PCOS血清LH和LH/FSH下降,窦卵泡数减少,差异均有统计学意义(P<0.01)。结论:华中地区PCOS临床表现以A型和B型多见,达因-35治疗3个周期可明显降低不同类型血清雄激素水平、血清LH水平和LH/FSH比值,减少窦卵泡数。
Objective: To investigate the effect of Dain-35 on serum hormones and antral follicles in different types of polycystic ovary syndrome (PCOS). Methods: 138 PCOS patients were classified according to the Rotterdam standard. 78 patients with tubal infertility who did not have hyperandrogenism and menstrual disorders during the same period were selected as the control group. The levels of serum reproductive hormones and fasting insulin (FINS) were measured. The volume of ovary and the count of antral follicles were detected by pelvic ultrasonography. The changes of these indexes were observed after three cycles of darrenaline-35 treatment, and the therapeutic effects of darine-35 on different types of PCOS were evaluated . Results: Type A [O / A] + HA + PCO], type B (O / A + PCO), type C (HA + O / A) and type D HA + PCO) were 43 cases, 73 cases, 15 cases and 7 cases. The levels of total testosterone (TT) and DHEAS in type A, type C and type D were higher than those in control group, and the levels of LH, LH / FSH, FINS and insulin evaluation index (HOMA-IR) Group, the difference was statistically significant (P <0.05). A type, B type and D type antral follicles more than C type and control group, the difference was statistically significant (P <0.05). After 3 cycles of Dane-35 treatment, the serum TT levels of type A, C and D decreased significantly (P <0.05), while the level of DHEAS decreased, but the difference was not statistically significant (P> 0.05) ; The serum levels of LH, LH / FSH and the number of antral follicles decreased in all kinds of PCOS patients, with statistical significance (P <0.01). Conclusion: The clinical manifestations of PCOS in Central China are more common in type A and type B. The three cycles of treatment with darun -35 can significantly reduce the levels of serum androgen, serum LH and LH / FSH, and decrease the number of antral follicles.