目的 观察雌二醇片/雌二醇地屈孕酮片对早发性卵巢功能不全（POI）患者卵巢储备功能及血清免疫指标的影响。方法 选取2022年2月—2023年8月福建中医药大学附属第三人民医院妇科收治的早发性卵巢功能不全患者60例,按随机数字表法分为对照组和研究组,对照组（30例）予常规激素替代疗法,研究组（30例）予雌二醇片/雌二醇地屈孕酮片。比较两组血清抗缪勒管激素（AMH）、卵泡刺激素（FSH）、雌二醇（E₂）、抗心磷脂抗体（ACA）、抗卵巢抗体（AOA）、抗β2糖蛋白1 IgM抗体（β2GP1-IgM）水平。结果 研究组治疗总有效率高于对照组,治疗后两组患者血清AMH、E₂水平均升高,血清FSH、ACA、AOA和β2GP1-IgM水平均降低（均P<0.05）,研究组临床疗效优于对照组,且不良反应发生率较低（P<0.05）。结论 雌二醇片/雌二醇地屈孕酮片可改善POI患者的卵巢储备功能,纠正机体自身免疫紊乱,其作用机制可能与免疫调节有关。

Objective To observe the effects of Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets on ovarian reserve function and serum immune indicators in patients with premature ovarian insufficiency. Methods Sixty patients with early-onset ovarian insufficiency admitted to the gynecology department of the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from February 2022 to August 2023 were selected and randomly divided into a control group（CG）and a study group（SG）using a random number table method．The CG（30 cases）received Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets．while the SG（30 cases）received Femoston．Compare two groups of serum anti-Müllerian hormone（AMH）,follicle stimulating hormone（FSH）,estradiol（E₂）,anticardiolipin antibody（ACA）,anti ovarian antibody（AOA）,and anti β2 Glycoprotein 1 IgM antibody（β2GP1 IgM）level. Results The total effective rate of the SG was higher than that of the control group（P<0.05）;Compared with before treatment,the serum levels of AMH and E₂ increased in both groups of patients after treatment,while serum levels of FSH,ACA,AOA and β The level of 2GP1 IgM decreased（P<0.05）,and the clinical efficacy of the SG was better than that of the CG,with a lower incidence of adverse reactions. Conclusions Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets can regulate the levels of sex hormones in patients with premature ovarian insufficiency,improve ovarian reserve function,correct autoimmune disorders in the body,and its mechanism of action may be related to immune regulation．

目的 探究炔雌醇环丙孕酮联合胰岛素增敏剂治疗多囊卵巢综合征疗效。方法 选取广东省第一荣军医院妇科2018年8月—2020年8月收治的100例多囊卵巢综合征患者作为研究对象,采用随机数字表法将患者分为对照组(n=50)和观察组(n=50),2组患者均给予炔雌醇环丙孕酮治疗,观察组此外联合胰岛素增敏剂治疗,比较2组患者治疗前、治疗30 d后血清性激素、抗缪勒管激素(AMH)水平、代谢指标水平以及临床疗效(包括排卵、妊娠等)。结果 治疗前,2组患者血清性激素、AMH水平比较,差异不具有统计学意义(P>0.05),治疗后,2组患者AMH、血清性激素水平均有所下降,且观察组低于对照组(P<0.05)。治疗前,2组患者代谢指标比较,差异不具有统计学意义(P>0.05),治疗后2组患者代谢指标水平均有所下降,且观察组低于对照组(P<0.05)。观察组治疗有效率高于对照组(P<0.05)。结论 使用单一药物治疗具有局限性,将炔雌醇环丙孕酮与胰岛素增敏剂相联合治疗能够有效降低患者胰岛素代谢指标水平以及性激素水平,提高患者受孕几率,具有良好的治疗效果。

Objective To explore the efficacy of ethinylestradiol and cyproterone combined with insulin sensitizer in the treatment of polycystic ovary syndrome. Methods A total of 100 patients with polycystic ovary syndrome treated in the Department of Gynecology of the First Invalids Hospital of Guangdong Province from August 2018 to August 2020 were selected as the research object. The patients were divided into control group (n=50) and observation group (n=50). The patients in both groups were given ethinylestradiol cyproterone. In addition, the observation group was treated with insulin sensitizer. The levels of serum sex hormone, anti-Müllerian hormone (AMH), metabolic index level and clinical efficacy (including ovulation, pregnancy, etc.) before treatment and 30 days after treatment were compared. Results Before treatment, the levels of serum sex hormone and AMH had no significant difference between two groups (P>0.05). After treatment, the levels of AMH and serum sex hormone both decreased in two groups, and those in observation group were lower than those in control group (P<0.05). Before treatment, it had no significant difference in metabolic indexes (P>0.05). After treatment, the levels of metabolic indexes in the two groups decreased, and those in observation group were lower than those in control group (P<0.05). The effective rate of the observation group was higher than the control group (P<0.05). Conclusions Using single drug treatment has limitations. The combination of ethinylestradiol cyproterone and insulin sensitizer can reduce insulin metabolism and sex hormone levels, improve the probability of pregnancy, which have a good therapeutic effect.

目的 探讨炔雌醇环丙孕酮联合二甲双胍对多囊卵巢综合征(PCOS)患者促排卵结局及性激素水平的影响。方法 选择2015年3月—2016年12月我院收治的多囊卵巢综合征(PCOS)患者90例,将其参照随机数字表法分为2组,各45例。对照组给予炔雌醇环丙孕酮治疗,在此基础上给予观察组二甲双胍治疗,1个疗程后评估两组临床疗效、性激素水平、药物不良反应,并观察治疗6个月后2组促排卵结局。结果 观察组治疗总有效率、排卵率、妊娠率均较对照组高,T、E₂、LH水平较对照组低,差异具有统计学意义(P＜0.05);观察组不良反应率与对照组相比,差异无统计学意义(P＞0.05)。结论 炔雌醇环丙孕酮联合二甲双胍可显著提高PCOS临床疗效,改善性激素水平及促排卵结局,且不增加不良反应率,安全性较高。

目的 分析惠州地区高尿酸血症患病率,探讨血清雌二醇水平与高尿酸症之间的相关性。方法 选择惠州市第一人民医院500名体检人员为研究对象,检测血清中尿酸浓度,女性同时检测雌二醇。结果 惠州地区高尿酸血症总患病率为23.2%(116/500),男性及女性分别为27.91%(72/258)和18.18%(44/242)(χ²＝6.628,P=0.010),不同性别血清尿酸浓度差异显著(Z=-15.961,P<0.001)。各年龄段男性血清尿酸水平(χ²=6.432,P=0.169)及患病率(χ²＝3.989,P=0.408)均相近。50岁以上女性患病率与男性无差异(χ²=0.088,P=0.766),20～49岁女性血清尿酸水平(Z=-3.856,P<0.001)及患病率(χ²=9.532,P=0.002)均低于50岁以上女性。20～49岁女性雌二醇高于50岁以上女性(Z＝-6.171,P<0.001),尿酸与雌二醇具有负相关性,r=-0.464。结论 除50岁以上女性外,惠州地区健康人群高尿酸血症患病率与国内多数地区人群相近,女性50岁进入绝经期后高尿酸血症患病率的快速上升与体内雌激素下降呈负相关。

Objective To analyze the prevalence rate of hyperuricemia (HUA) in Huizhou and investigate the relationship between HUA and estradiol(E2). Methods 500 health people from Huizhou first hospital were enrolled. Uric acid and E2 in female was detected. Results The overall prevalence rate of HUA was 23.2%(116/500). The prevalence rate of male and female were 27.91% (72/258)and 18.18%(44/242), respectively(χ²＝6.628,P=0.010). There was no significantly difference between male and female in the level of uric acid(Z=-15.961,P<0.001) The levels ofuricacid in serum(χ²=6.432,P=0.169)and the prevalence rate (χ²＝1.1,P>0.05)were closed to each age bracket in male group. The prevalence rate of male over 50 years old was closed to female(χ²=0.0144,P>0.05).In 20 to 49 years old female group, prevalence rate was lower(χ²=6.084,P<0.025) and uric acid in serum(χ²=17.599,P<0.001)was lower than that of the group over 50 years old. The levels of E2 of female under 50 years old was higher than that above 50 years old(χ²＝41.292,P<0.001).There was negative correlation between uric acid and E2, and the correlation coefficient was -0.464. Conclusion The prevalence rate of HUA in Huizhou is close to most area in China except female over 50 years old. After menopause, the rapid rise of prevalence rate of HUA in female is associated with the descending of E2.