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目的：探讨克罗米芬对子宫内膜，卵泡发育，血浆雌、孕激素水平及白细胞雌激素受体的影响。方法：应用阴道超声、放免法和放射配体结合法比较了２２例自然周期和２６例克罗米芬促排卵周期不孕症患者子宫内膜厚度、分型，成熟卵泡数和血浆雌二醇、孕酮浓度及外周血白细胞雌激素受体含量的变化。结果：（１）克罗米芬组围排卵期子宫内膜厚度小于自然周期组（Ｐ＜０．０５）；成熟卵泡数明显多于自然周期组（Ｐ＜０．０１）；子宫内膜分型两组间无明显差异（Ｐ＞０．０５）。（２）围排卵期血浆雌二醇、孕酮浓度，克罗米芬组均显著高于自然周期组（Ｐ＜０．０１）。（３）克罗米芬周期白细胞雌激素受体含量，最大结合容量（Ｂｍａｘ）及平衡解离常数（Ｋｄ）值均低于自然周期组（Ｐ＜０．０１）。结论：（１）克罗米芬使白细胞雌激素受体减少，并可能使子宫内膜雌激素受体减少，对雌二醇、孕酮的正向调节反应减弱，从而影响子宫内膜的容受性。（２）克罗米芬可致发育卵泡过早黄素化，影响促排卵周期妊娠率的提高。
Objective: To investigate the effect of clomiphene on endometrium, follicular development, plasma estrogen and progesterone levels and leukocyte estrogen receptor. Methods: Vaginal ultrasound, radioimmunoassay and radioligand binding method were used to compare the endometrial thickness, type, number of mature follicles and plasma levels of estradiol in 22 spontaneous cycles and 26 cases of clomiphene-induced ovulation cycle. Ketone concentration and peripheral blood leukocyte estrogen receptor content changes. Results: (1) The endometrial thickness of clomiphene group in ovulation period was less than that in natural period group (P <0.05); the number of mature follicles was more than that in natural period group (P <0.01) No significant difference between groups (P> 0.05). (2) Ovulation period plasma estradiol, progesterone concentration, clomiphene citrate group were significantly higher than the natural cycle group (P <0.01). (3) The leukocyte estrogen receptor content, maximum binding capacity (Bmax) and equilibrium dissociation constant (Kd) in the clomiphene citrate group were lower than those in the natural cycle group (P <0.01). Conclusion: (1) Clomiphene reduces the leukocyte estrogen receptor and may decrease the endometrial estrogen receptor and the positive regulation of estradiol and progesterone, thus affecting the endometrial receptivity . (2) Clomifene can cause premature luteinizing follicles, affecting the promotion of ovulation cycle pregnancy rate.