戊酸雌二醇联合枸橼酸西地那非治疗对薄型子宫内膜患者子宫内膜容受性及妊娠结局的影响

戊酸雌二醇联合枸橼酸西地那非治疗对薄型子宫内膜患者子宫内膜容受性及妊娠结局的影响

黄好,王晓霜

重庆市中医院,重庆市中医院

收稿日期:2017-07-19 修回日期:2017-07-19 出版日期:2017-11-25
基金资助:
重庆市卫计委面上项目(项目编号：2016MSXM075；项目名称：雌激素、阿司匹林联合枸橼酸西地那非治疗复发性流产患者子宫内膜容受性低下的临床研究）

Effects of Estradiol Valerate Combined with Sildenafil Citrate on Endometrial Receptivity and Pregnancy Outcome in Patients with Thin Endometrium

黄好 and Wang Xiaoshuang

Chongqing Traditional Medicine Hospital,Chongqing Traditional Medicine Hospital

Received:2017-07-19 Revised:2017-07-19 Online:2017-11-25

摘要/Abstract

摘要： 目的：探究戊酸雌二醇联合枸橼酸西地那非治疗对薄型子宫内膜患者子宫内膜容受性及妊娠结局的影响。方法：选取我院2014年9月至2016年5月收治的薄型子宫内膜患者90例作为研究对象，根据随机数表法将其分为观察组和对照组，每组各45例。所有患者均给予戊酸雌二醇口服治疗，在此基础上观察组患者予以枸橼酸西地那非口服治疗。比较两组患者治疗后子宫内膜情况、子宫动脉血流动力学参数及妊娠结局。结果：观察组患者子宫内膜厚于对照组，卵泡直径大于对照组，子宫内膜容积大于2 mL的个数多于对照组，A型子宫数亦多于对照组，且比较差异均有统计学意义(P<0.05)；观察组患者子宫动脉搏动指数、收缩指数明显小于对照组，平均流速快于对照组，且比较差异均有统计学意义(P<0.05)；观察组患者临床妊娠率(75.56%)高于对照组(53.33%)，差异有统计学意义(χ2=4.85， P=0.03)。结论：戊酸雌二醇联合枸橼酸西地那非能有效改善薄型子宫内膜患者子宫内膜的容受性，并对妊娠率的提高有积极作用。

Abstract: Objective：To investigate the effect of estradiol valerate combined with sildenafil citrate on endometrial receptivity and pregnancy outcome in patients with thin endometrium.Methods： Subjects were selected from our hospital from September 2014 to May 2016 treated 90 patients with thin endometrial disease，according to the random number table method， it was divided into observation group and control group，45 cases in each group. All patients were treated with estradiol valerate orally， on which the patients in observation group were treated with sildenafil citrate orally. The endometrial status， uterine artery hemodynamic parameters and pregnancy outcome were compared between the two groups after treatment.Results： In the observation group， endometrium was thicker than the control group， the follicle diameter was larger than that of the control group， the number of endometrial volume greater than 2 mL was higher than that of the control group， the number of type A uterus was also higher than that of the control group， and the difference was statistically significant(P<0.05). The uterine artery pulsatility index and contraction index of the observation group were significantly smaller than the control group， the average flow rate was faster than the control group， and the difference was statistically significant(P<0.05). The clinical pregnancy rate of the observation group was higher than that of the control group， and the difference was statistically significant(P<0.05).Conclusion： Estradiol valerate combined with sildenafil citrate can effectively improve the endometrial tolerance of patients with thin endometrium and have a positive effect on the improvement of pregnancy rate.

黄好,王晓霜. 戊酸雌二醇联合枸橼酸西地那非治疗对薄型子宫内膜患者子宫内膜容受性及妊娠结局的影响[J]. .

黄好 and Wang Xiaoshuang. Effects of Estradiol Valerate Combined with Sildenafil Citrate on Endometrial Receptivity and Pregnancy Outcome in Patients with Thin Endometrium[J]. .

参考文献

[1] 冯雪梅. 补肾活血法联合戊酸雌二醇对不孕症患者子宫内膜容受性及妊娠结局的影响[J]. 陕西中医, 2016, 37(11):1504-1506.
[2] Nappi R E, Terreno E, Sances G, et al. Effect of a contraceptive pill containing estradiol valerate and dienogest (E2V/DNG) in women with menstrually-related migraine (MRM)[J]. CONTRACEPTION, 2013, 88(3):369-375.
[3] Wasiak R, Filonenko A, Vanness D J, et al. Impact of estradiol-valerate/dienogest on work productivity and activities of daily living in European and Australian women with heavy menstrual bleeding[J]. J WOMENS HEALTH, 2013, 22(4):378.
[4] De L V, Fruzzetti F, Musacchio M C, et al. Effect of a new oral contraceptive with estradiol valerate/dienogest on carbohydrate metabolism[J]. CONTRACEPTION, 2013, 88(3):364-368.
[5] 史红珍, 林琳, 孙立娟,等. 不同雌激素对薄型子宫内膜患者子宫内膜容受性的影响[J]. 山西医药杂志, 2015(9):1050-1052.
[6] Grandi G, Xholli A, Napolitano A, et al. Pelvic Pain and Quality of Life of Women With Endometriosis During Quadriphasic Estradiol Valerate/Dienogest Oral Contraceptive. A Patient-Preference Prospective 24-Week Pilot Study.[J]. REPROD SCI, 2015, 22(5):626.
[7] Nelson A, Parke S, Mellinger U, et al. Efficacy and safety of a combined oral contraceptive containing estradiol valerate/dienogest: results from a clinical study conducted in North America[J]. J WOMENS HEALTH, 2013, 23(3):204-210.
[8] 史红珍, 林琳, 孙立娟,等. 促排卵后分别接受戊酸雌二醇、芬吗通雌二醇治疗的不孕症患者子宫内膜容受性观察[J]. 山东医药, 2015(28):65-67.
[9] Wang W, Bai W, Cui G, et al. The Effects of Estradiol Valerate and Remifemin on Norepinephrine Signaling in Ovariectomized Rat Brain. [J]. NEUROENDOCRINOLOGY, 2015, -3835(3):120-132.
[10] Gleicher N, Kim A, Michaeli T, et al. A pilot cohort study of granulocyte colony-stimulating factor in the treatment of unresponsive thin endometrium resistant to standard therapies. [J]. HUM REPROD, 2013, 28(1):172-7.
[11] Beija M, Salvayre R, Viguerie L D, et al. Colloidal systems for drug delivery: from design to therapy[J]. TRENDS BIOTECHNOL, 2012, 30(9):485-96.
[12] 赵诗艺, 刘英, 杨晓葵,等. 薄型子宫内膜冻融胚胎移植周期中应用雌二醇/雌二醇地屈孕酮的疗效观察[J]. 实用妇产科杂志, 2015, 31(4):270-273.
[13] Borst S E, Shuster J J, Zou B, et al. Cardiovascular risks and elevation of serum DHT vary by route of testosterone administration: a systematic review and meta-analysis[J]. BMC MED, 2014, 12(1):211.
[14] Saravi S S S, Arefidoust A, Yaftian R, et al. 17α-ethinyl estradiol attenuates depressive-like behavior through GABA A, receptor activation/nitrergic pathway blockade in ovariectomized mice[J]. J PSYCHOPHARMACOL, 2016, 233(8):1467-1485.
[15] 庞燕. 戊酸雌二醇联合中药补肾活血法对克罗米芬促排卵周期子宫内膜容受性的影响[J]. 现代中西医结合杂志, 2015(35):3922-3924.
[16] Ponda M P, Huang X, Odeh M A, et al. Vitamin D may not improve lipid levels: a serial clinical laboratory data study.[J]. CIRCULATION, 2012, 126(3):270.
[17] 黎雪茹, 王中海. 薄型子宫内膜的研究进展[J]. 中华妇幼临床医学杂志电子版, 2015, 11(1):109-112.
[18] Iliodromiti S, Blockeel C, Tremellen K P, et al. Consistent high clinical pregnancy rates and low ovarian hyperstimulation syndrome rates in high-risk patients after GnRH agonist triggering and modified luteal support: a retrospective multicentre study[J]. HUM REPROD, 2013, 28(9):2529-36.
[19] 邹红艳, 王细林, 赖玲玲,等. 惰性宫内节育器对薄型子宫内膜的影响[J]. 医学综述, 2013, 19(12):2250-2252.
[20] Fraser I S, Jensen J, Schaefers M, et al. Normalization of blood loss in women with heavy menstrual bleeding treated with an oral contraceptive containing estradiol valerate/dienogest[J]. CONTRACEPTION, 2012, 86(2):96-101.

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