Effects of tedrogesterone tablets combined with clomiphene on polycystic ovary syndrome with infertility and its influence on serum levels of apolipoprotein B/apolipoprotein A1 ratio, anti-mullerian hormone, advanced glycation end products

中国基层医药 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.06.005

Zhiying Ma, Zhi-Zhen Qin, Lifang Zhao, Q. Ren

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Abstract

Objective To observe the efficacy of tedrogesterone tablets combined with clomiphene on polycystic ovary syndrome(PCOS) with infertility, and investigate its influence on serum levels of apolipoprotein B/apolipoprotein A1 ratio(ApoB/ApoA1), anti-mullerian hormone(AMH), advanced glycation end products(AGEs). Methods From January 2017 to December 2018, 80 PCOS patients with infertility who met the criteria were screened and randomly divided into control group and observation group according to the digital table, with 40 cases in each group.The control group received clomiphene 50 mg/d, qd, and for 5 consecutive days.In the observation group, on the basis of the control group, tedrosterone tablet was added, 10 mg/time and qd, and continuously administered for 21 days.The two groups were treated for 4 menstrual cycles.The ovarian volume, follicular development, pregnancy rate, hormone levels, the endometrial receptivity, and serum ApoB/ApoA1, AMH, AGEs levels were compared between the two groups. Results After treatment, the ovarian volume[(5.62±0.87)cm3]of the observation group was significantly smaller than that of the control group[(7.94±1.03)cm3](t=7.722, P=0.000), and the maximum diameter of follicles in the observation group[(13.30±2.04)mm] was significantly larger than that in the control group[(11.12±1.83)mm](t=5.530, P=0.0001). The pregnancy rate in the observation group was significantly higher than that in the control group(χ2=4.990, P=0.025). The serum levels of follicle stimulating hormone(FSH)[(4.80±0.56)IU/L], luteinizing hormone(LH)[(7.35±0.11)IU/L], uterine pulse index(PI)(2.77±0.41), and uterine artery resistance index(RI)(0.61±0.09) in the observation group were significantly lower than those in the control group(t=5.003, P=0.000; t=6.449, P=0.000; t=5.304, P=0.000; t=5.008, P=0.000), and the estradiol(E2)[(190.51±23.11)ng/L] and endometrial thickness[(10.11±1.57)mm] were significantly higher than those in the control group(t=38.521, P=0.000; t=6.001, P=0.000). The serum levels of ApoB/ApoA1(0.62±0.08), AMH[(4.13±0.61)μg/L], and AGEs[(118.04±13.35)ng/L] in the observation group were significantly lower than those in the control group(t=5.553, P=0.000; t=5.790, P=0.000; t=18.043, P=0.000). Conclusion The efficacy of tedrogesterone tablets combined with clomiphene on PCOS with infertility is significant, and can down-regulate serum levels of ApoB/ApoA1, AMH, and AGEs. Key words: Tedrogesterone; Polycystic ovary syndrome; Clomiphene; Infertility, female; Apolipoprotein B; Apolipoprotein A; Anti-mullerian hormone; Glycosylation end products, advanced; Hormone

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丙孕酮片联合克罗米芬治疗多囊卵巢综合征不孕疗效及对血清载脂蛋白B/载脂蛋白A1比值、抗苗勒管激素、晚期糖基化终产物的影响

目的观察氢孕酮片联合克罗米芬治疗多囊卵巢综合征(PCOS)合并不孕症的疗效，并探讨其对血清载脂蛋白B/载脂蛋白A1比值(ApoB/ApoA1)、抗苗勒管激素(AMH)、晚期糖基化终产物(AGEs)水平的影响。方法筛选2017年1月~ 2018年12月符合标准的PCOS不孕患者80例，按数字表随机分为对照组和观察组，每组40例。对照组患者给予克罗米芬50 mg/d, qd，连续5 d。观察组在对照组的基础上加用睾酮片，10 mg/次，qd，连续给药21 d。两组均治疗4个月经周期。比较两组患者卵巢体积、卵泡发育、妊娠率、激素水平、子宫内膜容受性及血清ApoB/ApoA1、AMH、AGEs水平。结果治疗后，观察组卵巢体积[(5.62±0.87)cm3]显著小于对照组[(7.94±1.03)cm3](t=7.722, P=0.000)，卵泡最大直径[(13.30±2.04)mm]显著大于对照组[(11.12±1.83)mm](t=5.530, P=0.0001)。观察组妊娠率显著高于对照组(χ2=4.990, P=0.025)。观察组患者血清促卵泡激素(FSH)[(4.80±0.56)IU/L]、促黄体生成素(LH)[(7.35±0.11)IU/L]、子宫脉搏指数(PI)(2.77±0.41)、子宫动脉阻力指数(RI)(0.61±0.09)水平均显著低于对照组(t=5.003, P=0.000;t = 6.449, P = 0.000;t = 5.304, P = 0.000;t=5.008, P=0.000)，雌二醇(E2)[(190.51±23.11)ng/L]和子宫内膜厚度[(10.11±1.57)mm]均显著高于对照组(t=38.521, P=0.000;t = 6.001, P = 0.000)。观察组患者血清ApoB/ApoA1(0.62±0.08)、AMH[(4.13±0.61)μg/L]、AGEs[(118.04±13.35)ng/L]水平均显著低于对照组(t=5.553, P=0.000;t = 5.790, P = 0.000;t = 18.043, P = 0.000)。结论氢孕酮片联合克罗米芬治疗PCOS合并不孕症疗效显著，可下调血清ApoB/ApoA1、AMH、AGEs水平。关键词:黄体酮;多囊卵巢综合征;克罗米酚;女性不孕;载脂蛋白B;载脂蛋白A;她们血液中的抗苗勒氏管激素;糖基化终产物，先进;激素

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.