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    吕梁, 张楚, 严为巧, 朱彤, 黄晓洁, 宋雪梅. 促性腺激素释放激素拮抗剂预防早发型卵巢过度刺激综合征的临床研究[J]. 徐州医科大学学报, 2018, 38(1): 29-32.
    引用本文: 吕梁, 张楚, 严为巧, 朱彤, 黄晓洁, 宋雪梅. 促性腺激素释放激素拮抗剂预防早发型卵巢过度刺激综合征的临床研究[J]. 徐州医科大学学报, 2018, 38(1): 29-32.
    LYU Liang, ZHANG Chu, YAN Weiqiao, ZHU Tong, HUANG Xiaojie, SONG Xuemei. Clinical studies on GnRH-ant in the prevention of early ovarian hyperstimulation syndrome[J]. Journal of Xuzhou Medical University, 2018, 38(1): 29-32.
    Citation: LYU Liang, ZHANG Chu, YAN Weiqiao, ZHU Tong, HUANG Xiaojie, SONG Xuemei. Clinical studies on GnRH-ant in the prevention of early ovarian hyperstimulation syndrome[J]. Journal of Xuzhou Medical University, 2018, 38(1): 29-32.

    促性腺激素释放激素拮抗剂预防早发型卵巢过度刺激综合征的临床研究

    Clinical studies on GnRH-ant in the prevention of early ovarian hyperstimulation syndrome

    • 摘要: 目的评估促性腺激素释放激素拮抗剂(GnRH-ant)对预防早发型卵巢过度刺激综合征(OHSS)的临床效果。方法选取人绒毛膜促性腺激素(hCG)日直径> 14 mm的卵泡数≥25个或取卵获得的卵母细胞数≥20个,hCG日血清E2浓度≥5 000 pg/ml的174例OHSS高危病例入组,全部行全胚冷冻择期移植并给予扩容常规预防。GnRH-ant用药组(87例)于取卵日后第1天(D1)给予GnRH-ant 0.25 mg皮下注射,持续5天。对照组87例仅予常规治疗。检测2组取卵日(D0)及取卵后第2、4、6天(D2、D4、D6)血清血管内皮生长因子(VEGF)水平。结果用药组D4、D6的血VEGF水平明显低于对照组(P<0.05),D6的血细胞比容、腹腔积液深度明显低于对照组(P<0.05),住院天数短于对照组(P<0.01),中重度OHSS发生率(3.4%)低于对照组(P<0.05)。结论在取卵日后施用GnRH-ant对预防早发型OHSS有一定的临床效果,可减少腹腔积液,降低血细胞比容,改善OHSS患者的临床症状。GnRH-ant可降低VEGF的水平,但其机制还有待研究。GnRH-ant的应用简便、安全,可作为临床上OHSS高风险人群的预防用药。
      关键词:卵巢过度刺激综合征;促性腺激素释放激素拮抗剂;血管内皮生长因子;预防

       

      Abstract: Objective To evaluate the effects of gonadotropic releasing hormone antagonist (GnRH-ant) on the prevention of early ovarian hyperstimulation syndrome (OHSS). MethodsA total of 174 patients with high risk of OHSS were enrolled based on the following criteria: on HCG day ≥25 follicles with a diameter> 14 mm or ≥20 oocytes and ≥5 000 pg/ml serum E2 concentration. All the patients were subject to embryo freezing and scheduled transplantation in addition to routine expansion for OHSS prevention. The GnRH-ant group (n=87) was subcutaneously injected with 0.25 mg GnRH-ant on Day 1 after egg retrieval for five consecutive days. Patients in the control group was given routine therapy (n=87). The levels of serum vascular endothelial growth factor (VEGF) were measured on Days 0, 2, 4 and 6. ResultsThe treatment group produced remarkably lower levels of VEGF on Days 4 and 6, compared with the control group (P<0.05). Meanwhile, compared with the control, on Day 6 the treatment group showed marked decreases in hematocrit and ascite (P<0.05), hospitalization stay (P<0.01), and the incidence of moderate to severe OHSS (3.4%) (P<0.05). ConclusionsAdministration of GnRH-ant on the day of oocyte collection has certain preventive effects on early OHSS, which can reduce ascites and hematocrit, relieve symptoms, and reduce the level of VEGF level, but its mechanism remains to be studied. GnRH-ant is simple and safe to be used as a preventive approach for high-risk OHSS patients.

       

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