标题：地屈孕酮片对PCOS合并不孕患者的疗效及血清OSI、TOS的影响

      作者：渠淑云，党洁，翟瑶，杨鑫    陕西省核工业二一五医院妇科，陕西 咸阳 712000

      卷次： 2023年34卷5期

      【摘要】 目的 探讨地屈孕酮片对多囊卵巢综合征(PCOS)合并不孕患者的疗效及血清氧化应激指数(OSI)、血清总氧化态(TOS)的影响。方法 选取2019年 1月至 2022年1月在陕西省核工业二一五医院接受治疗的80例PCOS合并不孕患者进行研究。按不同治疗方法分为对照组和研究组各40例。对照组给予来曲唑治疗，研究组给予地屈孕酮片联合来曲唑治疗。治疗2个月后，比较两组患者治疗前后的孕酮(SP)、性激素[促卵泡生成激素(FSH)、促黄体生成激素(LH)、雌二醇(E2)]和血清OSI、TOS水平，以及治疗后两组患者的排卵率、妊娠率，治疗效果和不良反应发生率。结果 治疗前，两组患者的SP、FSH、LH、E2水平比较差异均无统计学意义(P>0.05)；治疗后，两组患者的SP、E2均较治疗前明显升高，且研究组患者的SP、E2水平分别为(18.96±2.68) ng/mL、(95.40±9.52) pg/mL，明显高于对照组的(15.22±2.02) ng/mL、(82.88±5.32) pg/mL，差异均有统计学意义(P<0.05)；治疗后，两组患者的FSH、LH均较治疗前明显降低，且研究组患者的FSH、LH水平分别(2.42±0.56) U/L、(5.48±1.09) IU/L，明显低于对照组的(4.65±0.83) U/L、(8.24±1.49) IU/L，差异均具有统计学意义(P<0.05)；治疗前，两组患者的OSI、TOS水平比较差异无统计学意义(P>0.05)；治疗后，两组患者的OSI、TOS均较治疗前明显降低，且研究组患者的OSI、TOS水平分别为 8.13±1.05、(14.39±1.02) mmol H2O2 equiv/L，明显低于对照组的 10.08±1.45、(15.54±1.71) mmol H2O2 equiv/L，差异均有统计学意义(P<0.05)；研究组患者治疗后的排卵率、妊娠率分别为80.0%、45.0%，明显高于对照组的15.0%、12.5%，差异均有统计学意义(P<0.05)；研究组患者的治疗总有效率为97.5%，明显高于对照组的77.5%，差异有统计学意义(P<0.05)；研究组患者的不良反应总发生率为15.0%，略高于对照组的7.5%，但差异无统计学意义(P>0.05)。结论 地屈孕酮片治疗PCOS合并不孕能有效改善患者的血清OSI、TOS水平，提高排卵率和妊娠率，临床治疗效果显著。
      【关键词】 地屈孕酮片；多囊卵巢综合征；不孕；血清氧化应激指数；血清总氧化态；治疗效果
      【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350（2023）05—0663—04

Efficacy of Didroxyprogesterone Tablets in the treatment of polycystic ovary syndrome complicating infertility andits effects on serum oxidative stress index and total oxidative state.
QU Shu-yun, DANG Jie, ZHAI Yao, YANG Xin.Department of Gynecology, No. 215 Hospital of Nuclear Industry of Shaanxi Province, Xianyang 712000, Shaanxi, CHINA
【Abstract】 Objective To investigate the effect of Didroprogesterone Tablet in the treatment of polycystic ova-ry syndrome (PCOS) patients with infertility and the influence on serum oxidative stress index (OSI) and total oxidativestate (TOS). Methods Eighty patients with PCOS and infertility who were treated in No. 215 Hospital of Nuclear In-dustry of Shaanxi Province from January 2019 to January 2022 were selected for the study. According to different treat-ments, the patients were divided into a control and a study group, each with 40 patients. The control group was treatedwith letrozole, and the study group was treated with Didrogesterone Tablets combined with letrozole. After 2 months oftreatment, the levels of progesterone (SP), sex hormones [follicle stimulating hormone (FSH), luteinizing hormone (LH),estradiol (E2)], serum OSI, TOS, ovulation rate, pregnancy rate, treatment effect, and adverse reaction rate before and af-ter treatment were compared between the two groups. Results Before treatment, there was no significant difference inthe levels of SP, FSH, LH, and E2 between the two groups (P>0.05); after treatment, the levels of SP and E2 in the twogroups were significantly higher than those before treatment, and the levels of SP and E2 in the study group were (18.96±2.68) ng/mL and (95.40±9.52) pg/mL, which were significantly higher than (15.22±2.02) ng/mL and (82.88±5.32) pg/mLin the control group, with statistically significant differences (P<0.05). After treatment, FSH and LH in the two groups weresignificantly lower than those before treatment, and the levels of FSH and LH in the study group were (2.42±0.56) U/L and(5.48±1.09) IU/L, which were significantly lower than (4.65±0.83) U/L and (8.24±1.49) IU/L in the control group, with sta-tistically significant differences (P<0.05). Before treatment, there was no significant difference in the levels of OSI andTOS between the two groups (P>0.05); after treatment, the levels of OSI and TOS in the two groups were significantly low-er than those before treatment, and the levels of OSI and TOS in the study group were 8.13±1.05 and (14.39±1.02) mmolH2O2 equiv/L, which were significantly lower than 10.08 ± 1.45 and (15.54 ± 1.71) mmol H2O2 equiv/L in the controlgroup, with statistically significant differences (P<0.05). The ovulation rate and pregnancy rate of the patients in thestudy group after treatment were 80.0% and 45.0%, which were significantly higher than 15.0% and 12.5% in the controlgroup, and the difference was statistically significant (P<0.05). The total effective rate of the study group was 97.5%,which was significantly higher than 77.5% of the control group (P<0.05). The total incidence of adverse reactions in thestudy group was 15.0% versus 7.5% in the control group, with no significant difference between the two groups (P>0.05). Conclusion Didroprogesterone Tablet can effectively improve the serum OSI and TOS levels of patients withPCOS complicated with infertility, and increase the ovulation rate and pregnancy rate, which has significant effect and isworth promoting.
      【Key words】 Didroxyprogesterone Tablets; Polycystic ovary syndrome; Infertility; Serum oxidative stress index;Serum total oxidation state; Treatment effect