羟乙基淀粉溶液对卵巢过度刺激综合征的预防作用

doi:10.13481/j.1671-587x.20160619

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (06): 1147-1150.doi: 10.13481/j.1671-587x.20160619

羟乙基淀粉溶液对卵巢过度刺激综合征的预防作用

郭莉, 张晓霞, 于美玲, 赵婷, 张利群

吉林大学第一医院妇科, 吉林长春 130021

收稿日期:2016-03-15 出版日期:2016-11-28 发布日期:2016-12-02
通讯作者: 张利群,副主任医师,硕士研究生导师(Tel:0431-81875251,E-mail:zlq0812@163.com) E-mail:zlq0812@163.com
作者简介:郭莉(1990-),女,山东省临沂市人,在读医学硕士,主要从事生殖内分泌方面的研究。
基金资助:
吉林省科技厅自然科学基金资助课题（201215046）

Preventive effect of hydroxyethyl starch solution on ovarian hyperstimulation syndrome

GUO Li, ZHANG Xiaoxia, YU Meiling, ZHAO Ting, ZHANG Liqun

Department of Gynecology, First Hospital, Jilin University, Changchun 130021, China

Received:2016-03-15 Online:2016-11-28 Published:2016-12-02

摘要/Abstract

摘要：

目的：探讨卵巢过度刺激综合征（OHSS）的高危因素，研究羟乙基淀粉溶液对OHSS的预防作用。方法：将接受体外受精-胚胎移植（IVF-ET）的192例OHSS高危患者随机分成试验组（101例，自取卵24h内静脉滴注羟乙基淀粉溶液500 mL·d^-1，连续3 d）和对照组（91例，未给予任何药物）。比较2组患者的一般资料、OHSS发生率和中、重度OHSS的发生率；采用Logistic回归分析法分析中、重度OHSS的相关因素。结果：Logistic回归分析，年龄较小和体质量指数较小为OHSS的保护因素（OR<1）；而注射人绒毛膜促性腺激素（HCG）当日雌二醇（E2）值过高和取卵穿刺卵泡数过多为OHSS的危险因素（OR>1）。试验组患者OHSS发生率为31.68%（32/101），其中中度OHSS总发生率为20.79%（21/101），重度OHSS发生率为10.89%（11/101）；对照组患者OHSS总发生率为46.15%（42/91），其中中度OHSS发生率为26.37%（24/91），重度OHSS发生率为19.78%（18/98）。试验组患者OHSS总发生率和重度OHSS发生率明显低于对照组（χ²=4.23，P<0.05；χ²=2.95，P<0.05）。结论：年龄、体质量指数、注射HCG当日E2值和取卵穿刺卵泡数是OHSS发生的危险因素，对预测OHSS发生有重要意义；羟乙基淀粉溶液能降低OHSS发生率，对重度OHSS有较好的预防作用。

关键词: 羟乙基淀粉溶液, 高危因素, 人绒毛膜促性腺激素, 卵巢过度刺激综合征, 雌二醇

Abstract:

Objective: To explore the risk factors of ovarian hyperstimulation syndrome(OHSS), and to study the intravenously injected with preventive effect of hydroxyethyl starch solution on OHSS.Methods: A randomly prospective clinical trial including 192 fertilization-embryotransfer(IVF-ET) patients with high risk of OHSS was performed in vitro,and the patients were randomly divided into experimental group(n=101) and control group(n=91).The patients in experimental group were intravenously injected with 500 mL hydroxyethyl starch solution per day during 24 h of oocyte retrieval and lasted for 3 d;the patients in control group were not treated with any drugs.The general data,the incidence of OHSS,and the incidence of moderate and severe OHSS of the patients in two groups were compared; the relative factors of moderate and severe OHSS were analyzed by Logistic regression analysis.Results: The Logistic regression analysis results showed that the smaller age and body mass index were the protective factors of OHSS (OR<1)and the higher E2 value on the human chorionic gonadotropin(HCG) injection day and the larger number of follicles taken from the oocytes(OR>1) were the risk factors of OHSS.The incidence of OHSS of the patients in experimental group was 31.68%(32/101),which included 21 cases of moderate OHSS (20.79%) and 11 cases of severe OHSS(10.89%);the incidence of OHSS in control group was 46.15%(42/91),which included 24 cases of moderate OHSS(26.37%) and 18 cases of severe OHSS(19.78%);the incidence of OHSS and severe OHSS of the patients in experimental group was significantly lower than those in control group(χ²=4.23,P<0.05;χ²=2.95,P<0.05).Conclusion: Age,body mass index,E2 value on the HCG injection day,and the number of follicles taken from the oocytes are the related factors of OHSS,and play an important role in predicting the incidence of OHSS;hydroxyethyl starch solution can markedly decrease the incidence of OHSS,and has better preventive effect on severe OHSS.

Key words: hydroxyethyl starch, high risk factor, human chorionic gonadotropin, ovarian hyperstimulation syndrome, estradiol

中图分类号:

R711.75

郭莉, 张晓霞, 于美玲, 赵婷, 张利群. 羟乙基淀粉溶液对卵巢过度刺激综合征的预防作用[J]. 吉林大学学报(医学版), 2016, 42(06): 1147-1150.

GUO Li, ZHANG Xiaoxia, YU Meiling, ZHAO Ting, ZHANG Liqun. Preventive effect of hydroxyethyl starch solution on ovarian hyperstimulation syndrome[J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1147-1150.

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羟乙基淀粉溶液对卵巢过度刺激综合征的预防作用

Preventive effect of hydroxyethyl starch solution on ovarian hyperstimulation syndrome

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