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目的探讨仿生物电治疗对薄型子宫内膜的发育和患者妊娠结局的影响。方法选取2012年1月-2015年6月在该院不孕门诊就诊的薄型子宫内膜患者46例为研究对象。患者接受促排卵治疗,从D8日开始口服补佳乐,部分患者同时接受仿生物电刺激治疗。观察比较患者治疗前(D8)、治疗后(hCG日)子宫内膜厚度、内膜形态,内膜下动脉血流阻力指数(RI);追踪患者临床妊娠结局。将单纯口服补佳乐的周期合并为对照组,口服补佳乐的基础上完成完整的仿生物刺激治疗周期合并为观察组,比较两组上述指标的差异。结果对照组周期共计90个,涉及30例患者;观察组周期共计82个,涉及28例患者。两组周期(患者)的年龄、不孕年限、基础窦卵泡计数(AFC)、体质量指数(BMI)、D3日基础血清促卵泡激素(bFSH)等水平的比较,差异无统计学意义(P>0.05)。治疗后,两组患者平均子宫内膜厚度均有所增加,A型子宫内膜比例上升。观察组改善的效果更为明显,两组治疗后内膜厚度、A型内膜比例比较,差异均有统计学意义(P<0.05)。治疗后,对照组RI值无明显变化,观察组RI值明显下降,两组治疗后RI值比较,差异有统计学意义(P<0.05)。观察组周期妊娠率和流产率与对照组比较,差异无统计学意义(P>0.05)。结论薄型子宫内膜患者在口服雌激素的同时,联合仿生物电刺激治疗,可降低内膜下动脉血流阻力,进一步刺激内膜生长,促进内膜向A型转化;可能提高周期妊娠率,从而改善妊娠结局。
Objective To investigate the effects of biomimetic electrotherapy on the development of thin endometrium and pregnancy outcome. Methods Forty-six patients with thin endometrium treated in infertility clinics from January 2012 to June 2015 were selected as study objects. Patients received ovulation induction treatment, starting from the D8 daily delivery of good health, some patients also receive biomimetic electrical stimulation. The patients’ pre-treatment (D8), post-treatment (hCG) endometrial thickness, endometrial morphology and subintimal arterial resistance index (RI) were observed and compared. Clinical pregnancy outcomes were followed up. The simple oral gonadotropin cycle was merged into the control group. Based on the oral gonadotropin, complete complete cycle of biostimulation treatment was merged into the observation group, and the difference of the above indexes was compared between the two groups. Results The control group had a total of 90 cycles involving 30 patients. The observation group had a total of 82 cycles involving 28 patients. There were no significant differences in age, duration of infertility, AFC, BMI and bFSH between the two groups (P > 0.05). After treatment, the average thickness of endometrial in both groups increased, and the proportion of type A endometrium increased. The effect of the observation group was more obvious. There was significant difference between the two groups in the thickness of intima and the ratio of type A endometrium (P <0.05). After treatment, there was no significant change in the RI value of the control group, and the RI value of the observation group decreased significantly. There was significant difference in RI between the two groups after treatment (P <0.05). The pregnancy rate and abortion rate in the observation group were not significantly different from those in the control group (P> 0.05). Conclusion In patients with thin endometrium, oral estrogen combined with biomimetic electrical stimulation can reduce the blood flow resistance of the subarterial artery, further stimulate the growth of the intima and promote the transformation of the intima into type A. It may increase the rate of pregnancy, Thus improving pregnancy outcome.