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目的:观察地屈孕酮片联合氯米芬对多囊卵巢综合征(PCOS)不孕症患者的疗效，并探讨该治疗方案对患者血清载脂蛋白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月至2018年12月在绍兴市中心医院治疗的PCOS不孕症患者共80例，按照随机数字表法分为对照组和观察组各40例。对照组：给予氯米芬，50 mg/d，1次/d，连续5 d。观察组在对照组基础上加用地屈孕酮片，10 mg/次，1次/d，连续服药21 d。两组疗程为4个月经周期。比较两组患者的卵巢体积和卵泡发育、妊娠率、激素水平、子宫内膜容受性以及血清ApoB/ApoA1、AMH、AGEs水平。结果:疗程结束后，观察组患者的卵巢体积(5.62±0.87)cmn 3，显著小于对照组的(7.94±1.03)cmn 3(n t＝7.722，n P＝0.000)；卵泡最大直径(13.30±2.04)mm，明显大于对照组的(11.12±1.83)mm(n t＝5.530，n P＝0.000)；观察组妊娠率显著高于对照组(χn 2＝4.990，n P＝0.025)；观察组患者疗程后血清卵泡刺激素(FSH)(4.80±0.56)IU/L、黄体生成素(LH)(7.35±0.11)IU/L、子宫动脉搏动指数(PI)(2.77±0.41)、子宫动脉阻力指数(RI)(0.61±0.09)，均显著低于对照组(n t＝5.003，n P＝0.000；n t＝6.449，n P＝0.000；n t＝5.304，n P＝0.000；n t＝5.008，n P＝0.000)，雌二醇(En 2)(190.51±23.11)ng/L、子宫内膜厚度(10.11±1.57)mm，明显高于对照组(n t＝38.521，n P＝0.000；n t＝6.001，n P＝0.000)；观察组患者疗程结束后血清ApoB/ApoA1(0.62±0.08)、AMH(4.13±0.61)μg/L、AGEs(118.04±13.35)ng/L，显著少于对照组(n t＝5.553，n P＝0.000；n t＝5.790，n P＝0.000；n t＝18.043，n P＝0.000)。n 结论:地屈孕酮片联合氯米芬对多囊卵巢综合征不孕症的疗效明显，且可下调血清ApoB/ApoA1比值、AMH、AGEs水平。“,”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)cmn 3]of the observation group was significantly smaller than that of the control group[(7.94±1.03)cmn 3](n t=7.722, n 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](n t=5.530, n P=0.0001). The pregnancy rate in the observation group was significantly higher than that in the control group(χn 2=4.990, n 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(n t=5.003, n P=0.000; n t=6.449, n P=0.000; n t=5.304, n P=0.000; n t=5.008, n P=0.000), and the estradiol(En 2)[(190.51±23.11)ng/L] and endometrial thickness[(10.11±1.57)mm] were significantly higher than those in the control group(n t=38.521, n P=0.000; n t=6.001, n 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(n t=5.553, n P=0.000; n t=5.790, n P=0.000; n t=18.043, n P=0.000).n 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.