摘要
目的探究粒细胞集落刺激因子(G-CSF)联合他达拉非(TD)对薄型子宫内膜(TE)患者子宫内膜容受性和妊娠结局的影响。方法选取2020年5月至2023年3月秦皇岛市第一医院生殖医学科TE患者为研究对象。根据治疗方案不同分为试验组(G-GSF联合TD)和对照组(G-GSF)。比较治疗前和治疗后(内膜转化日)TE患者子宫内膜容受性[子宫内膜厚度(EMT)、子宫内膜容积(EMV)、子宫内膜血流收缩期峰值流速/舒张末期流速(EBF-S/D)、子宫内膜分型、子宫内膜血流分型、子宫动脉搏动指数(AUPI)、子宫动脉阻力指数(AURI)和子宫动脉收缩期峰值流速/舒张末期流速(AU-S/D)];比较两组患者内膜转化日子宫内膜容受性、治疗后妊娠结局[胚胎种植率(EIR)、临床妊娠率(CPR)和早期流产率(ABR)]及治疗期间不良反应发生情况。结果研究共纳入60例患者,每组30例。治疗前,两组患者子宫内膜容受性差异无统计学意义(P>0.05)。与治疗前比较,治疗后两组患者内膜转化日EMT、EMV、A型子宫内膜比例和II型+III型子宫内膜血流比例显著增加(P<0.05),而EBF-S/D、AUPI、AURI和AU-S/D显著下降(P<0.05)。试验组EMT和EMV大于对照组(P<0.05),而EBF-S/D、AUPI、AURI和AU-S/D小于对照组(P<0.05)。与对照组相比,试验组子宫内膜形态、子宫内膜血流分型、EIR、CPR、ABR差异均无统计学意义(P>0.05)。两组患者在治疗期间均未发生不良反应。结论G-CSF联合TD可改善TE患者子宫内膜容受性,安全性较高,但对妊娠结局尚无影响。
Objective To investigate the effects of granulocyte colony-stimulating factor(G-CSF)combined with tadalafil(TD)on endometrial receptivity and pregnancy outcomes in patients with thin endometrium(TE).Methods Patients with TE in the department of reproductive medicine of the First Hospital of Qinhuangdao from May 2020 to March 2023 were selected as the study subjects.They were divided into a experimental group(G-GSF combined with TD)and a control group(G-GSF)according to the different treatment regimens.The endometrial receptivity[endometrial thickness(EMT),endometrial volume(EMV),endometrial blood flow peak systolic flow rate/end diastolic flow rate(EBF-S/D),endometrial fractionation,endometrial blood flow fractionation,uterine artery pulsatility index(AUPI),uterine artery resistance index(AURI)and uterine arterial peak systolic flow rate/end diastolic flow rate(AU-S/D)]of the TE patients before and after treatment(the endometrial transition day)were compared;the endometrial receptivity on endometrial transformation day,post-treatment pregnancy outcomes[embryo implantation rate(EIR),clinical pregnancy rate(CPR),and early miscarriage rate(ABR)],and the incidence of adverse reactions during treatment were compared between the two groups.Results A total of 60 patients were included in the study,with 30 in each group.Before treatment,the difference in endometrial receptivity between the two groups was not statistically significant(P>0.05).Compared with the pre-treatment period,the EMT,EMV,the proportion of type A endometrium and the proportion of type II+III endometrial blood flow significantly increased in the two groups after treatment on the endometrial transformation day increased significantly(P<0.05),while the EBF-S/D,AUPI,AURI and AU-S/D significantly decreased(P<0.05).EMT and EMV were greater in the experimental group than in the control group(P<0.05),whereas EBF-S/D,AUPI,AURI and AU-S/D were less than those in the control group(P<0.05).Compared with the control group,the differences in the proportion of endometrium,the proportion of endometrial blood flow,EIR,CPR and ABR in the experimental group were not statistically significant(P>0.05).No adverse reactions occurred during treatment in both groups.Conclusion G-CSF combined with TD can improve endometrial receptivity in TE patients with high safety,but there is no effect on pregnancy outcome.
作者
史红珍
孙立娟
王琳
王倩
张爽
林琳
SHI Hongzhen;SUN Lijuan;WANG Lin;WANG Qian;ZHANG Shuang;LIN Lin(Department of Reproductive Medicine,The First Hospital of Qinghuangdao,Qinhuangdao 066000,Hebei Province,China;Department of Ultrasound Diagnosis,The First Hospital of Qinghuangdao,Qinhuangdao 066000,Hebei Province,China)
出处
《中国药师》
CAS
2024年第6期984-991,共8页
China Pharmacist
基金
秦皇岛市科学技术研究与发展计划(202301A166)。
