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目的:探讨卵巢过度刺激综合征(OHSS)高危患者在取卵后应用不同剂量来曲唑(LE)预防早发型OHSS发生的效果。方法:88例患者随机分为4组,A~C组为LE组,取卵即日起每日添加LE,LE剂量分别为A组(n=21)2.5 mg/d,B组(n=23)5.0 mg/d,C组(n=20)7.5 mg/d,D组为对照组(n=24)。测患者黄体期内分泌、血管内皮细胞生长因子(VEGF)水平及中重度OHSS发生率。结果:h CG注射后第5日始血清E_2水平随时间变化呈降低趋势,随着LE剂量增加,E_2水平降低速度明显加快,组间差异有统计学意义(P<0.05)。血清LH水平在注射h CG后第8日、第10日随着LE剂量的增加而逐渐上升,P水平却逐渐降低,组间差异显著(P<0.05)。血清VEGF水平从h CG注射后5日始,D组呈上升趋势,而其它三组呈下降趋势,随着LE剂量的增加,血中VEGF水平越低,各组之间两两比较,差异均具有统计学意义(P<0.001)。C组中重度OHSS发生率低于D组。结论:不同剂量的LE均能一定程度降低血清E_2及VEGF水平,当剂量增至7.5 mg/d时,OHSS发生率最低。
Objective: To investigate the effect of different doses of letrozole (LE) on the prevention of early-onset OHSS in ovarian hyperstimulation syndrome (OHSS) high-risk patients after ovulation. Methods: A total of 88 patients were randomly divided into 4 groups. Groups A to C were LE group. The daily LE dose was obtained immediately after ovulation. The dose of LE was 2.5 mg / d in group A (n = 21), 2.5 mg / d in group B ) 5.0 mg / d, group C (n = 20) 7.5 mg / d, group D as control group (n = 24). Luteal phase of patients with endocrine, vascular endothelial growth factor (VEGF) levels and the incidence of moderate-severe OHSS. Results: The serum E2 level on the 5th day after h CG injection tended to decrease with time. With the increase of LE dose, the decrease of E_2 level was significantly accelerated with a significant difference between the two groups (P <0.05). The levels of serum LH increased gradually with the increase of LE dose on the 8th and the 10th days after h CG injection, while the levels of P decreased gradually with significant difference (P <0.05). The level of VEGF in serum increased from the 5th day after h CG injection, while the other three groups showed a decreasing trend. With the increase of LE dose, the lower the level of VEGF in blood, the difference between every two groups Statistically significant (P <0.001). The incidence of severe OHSS in group C was lower than that in group D. CONCLUSION: Different doses of LE can decrease serum E_2 and VEGF levels to some extent. When the dosage is increased to 7.5 mg / d, the incidence of OHSS is the lowest.