强的松及万汶对中、重度卵巢过度刺激综合征预防作用的比较

摘要/Abstract

摘要： 目的: 研究比较强的松及万汶(6％中分子羟乙基淀粉130/0.4)的应用对卵巢过度刺激综合征(OHSS)高危患者中、重度OHSS发病的预防作用。方法: 2009年10月至2010年9月行体外受精-胚胎移植(IVF-ET)治疗的OHSS高危患者(注射日血雌二醇≥4000 pg/mL 或获卵数≥15个)207例,共207个治疗周期,随机将其分成口服强的松组(A组,66个周期)、静脉滴注万汶组(B组,75个周期)及两者合用组(C组,66个周期)。A组患者从人绒毛膜促性腺激素(hCG)注射日起口服强的松片 5 mg tid×2 d,后改为 5 mg bid×5 d;B组患者于取卵日起予以万汶 500 mL×3 d;C组患者则为同时应用上述两种药物治疗。根据Golan分类标准,对3组患者中、重度OHSS的发病率及其他相关指标进行统计学分析。结果: A组共移植60个周期,妊娠率为 50.0％,中、重度OHSS的发病率为 3.03%;B组共移植65个周期,妊娠率为 44.6％,中、重度OHSS的发病率为 13.33%;C组共移植59个周期,妊娠率为 42.4％,中、重度OHSS的发病率为 3.03%,3组间比较妊娠率无统计学差异(P>0.05),但B组的中、重度OHSS发病率明显高于A组及C组,差异有统计学意义(P<0.05)。结论: 口服强的松预治疗不影响IVF-ET妊娠结局,与静脉滴注万汶相比能更经济、方便及有效地预防中、重度OHSS的发生。

关键词: 体外受精-胚胎移植, 卵巢过度刺激综合征, 强的松, 万汶

Abstract: AIM: To compare the efficiency of prednisone and 6% hydroxyethylstarch in the prevention of moderate and severe ovarian hyperstimulation syndrome (OHSS). METHODS: A total of 207 OHSS high-risk patients and 207 cycles of in vitro fertilization and embryo transfer (IVF-ET) programme with estradiol serum concentration≥4000 pg/mL on the day of hCG injection and/or≥15 oocyte collection were prospective and randomized divided into A, B and C three groups. The patients in group A (66 cycles) orally took prednisone 5 mg tid on the day of hCG injection for 2 d, and then changed to 5 mg qd for 5 d; the patients in group B (75 cycles) were infused with 500 mL 6% hydroxyethylstarch on the day of oocyte collection for 3d; the patients in group C (66 cycles) were treated with prednisone and hydroxyethylstarch. The incidence of moderate and severe OHSS and the other corresponding indexes among the three groups were analyzed. RESULTS: There have 60 cycles were transferred in group A, clinical pregnancy rate was 50% and the incidence of moderate and severe OHSS was 3.03%; 65 cycles were transferred in group B, clinical pregnancy rate was 44.6%, and the incidence of moderate and severe OHSS was 13.33%; 59 cycles were transferred in group C, clinical pregnancy rate was 42.4% and the incidence of moderate and severe OHSS was 3.03% .There was no significant difference in pregnancy outcome among the three groups (P>0.05), but the incidence of moderate and severe OHSS in group B was higher than those in group A and group C (P<0.05). CONCLUSION: Oral administration of prednisone have no effect on pregnant rate of IVF and it is a cheaper, more convenient and effective alternative to 6% hydroxyethylstarch in moderate and severe OHSS prevention.

Key words: In vitro fertilization, Ovarian hyperstimulation syndrome, Prednisone, Hydroxyethylstarch

中图分类号:

杨海燕, 赵军招, 林文琴, 林金菊, 余蓉. 强的松及万汶对中、重度卵巢过度刺激综合征预防作用的比较[J]. 中国临床药理学与治疗学, 2011, 16(6): 652-656.

YANG Hai-yan, ZHAO Jun-zhao, LIN Wen-qin, LIN Jin-ju, RU Rong. Comparison of prednisone versus hydroxyethylstarch for prevention of moderate and severe ovarian hyperstimulation syndrome[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(6): 652-656.

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