The Observation Of The Effect Of Hydroxyethyl Starch 130/0.4 And Electrolyte Injection(Balanced Voluven) On Early-onset And Moderate And Severe Ovarian Hyperstimulation Syndrome

Objective:To observe the effect of Hydroxyethyl Starch 130/0.4 and Electrolyte Injection(Balanced Voluven) on early-onset and moderate and severe Ovarian Hyperstimulation Syndrome(OHSS),with albumin as a control, and to explore the correlation between IL-18 and OHSS and explore the variation of the Overhydration (△OH) in OHSS.Methods:Choose 60 patients with early-onset and moderate and severe ovarian hyperstimulation syndrome from February 2014 to December 2014 with in vitro fertilization-embryo transfer, divided into two groups:experimental group of 30 patients with Hydroxyethyl Starch 130/0.4 and Electrolyte Injection(Balanced Voluven),1000ml, ivgtt,5days; control group of 30 patients with Albumin,12.5g, ivgtt,5days. Measure the change of systolic blood pressure, diastolic blood pressure, heart rate, routine blood indicators, biochemical indicators, abdominal perimeter,weight,24 hours uterine before、after 3days and after 5 days treatment, and measure pelvic fluid and interlukin (IL)-18 level in serum of patients before and after 5 days. And after 1 day、3days、5days treatment, before and after liquid infusion of two groups △ OH level also be measured. After statistical analysis, to access the efficacy.Results:1.The comparison of age, weight, BMI, FSH, LH, T, bilateral antral follicles counts, the E2 levels of the day of HCG injection, the advantage number of follicles, number of eggs between Balanced Voluven group with Albumin group have not statistically significant(P>0.05).2.The hemodynamic indicator:comparison between groups:before treatment, the systolic blood pressure, diastolic blood pressure and heart rates of the two groups have not statistically significant(P>0.05).Comparison in the group:after 3 days treatment, the systolic blood pressure of two groups is higher than before treatment, which has statistically significant(P<0.05).3.Blood routine indicator:comparison between groups:after 3 days treatment, white blood cells count of Balanced Voluven group is lower than Albumin group, which has statistically significant(P<0.05); after 3 days、5 days treatment, the percentage of neutrophils of Balanced Voluven group is lower than Albumin group, which has statistically significant(P<0.05); after 5 days treatment,platelet count between two groups has statistically significant(P<0.05).Comparison in the group:Balanced Voluven group:white blood cells count of after 3 days treatment is lower than that of before treatment, there is statistically significant (P<0.05).Albumin group:after 5 days treatment, white blood cells count and the percentage of neutrophils are lower than that of before treatment, there is statistically significant(P<0.05).4.Biochemical indicator:comparison between groups:after 3 days、5 days treatment, albumin and total protein of Balanced Voluven group are lower than Albumin group, there is statistically significant(P<0.05).Comparison in the group:Balanced Voluven group:the urea nitrogen and creatinine of after 5 days treatment are higher than before and after 3 days treatment, there is statistically significant(P<0.05);Albumin group:the urea nitrogen after 3 days、5 days treatment are higher than before treatment, there is statistically significant(P<0.05).5.Syndrome:Comparison between groups:before and after 3 days、5 days treatment, abdominal circumference, body weight, urine volume of two groups have not statistically significant(P>0.05);before and 5 days treatment, the difference of pelvic fluid of two groups, has not statistically significant (P>0.05).Comparison in the group:after 5 days treatment compare with before treatment,24 hours uterine output of two groups increase significantly, with a statistically significant (P<0.05).6.The change of IL-18 level:Comparison in the group:IL-18 content before treatment of Balanced Voluven group and Albumin group is higher than after treatment, there is statistically significant(P<0.05).Comparison between groups:IL-18 content before treatment and after treatment, respectively, has not statistically significant(P>0.05).7.The change of △OH:OH of before and after liquid infusion after lday、3days、 5days treatment, the comparison of Balanced Voluven group with Albumin group has statistically significant(P<0.05). after 1day、3days、5days treatment,the comparison of △OH has not statistically significant (P>0.05).8.Comparison of the total clinical efficacy:After 5days treatment, Balanced Voluven group and Albumin group, respectively, the total clinical efficacy was 90% and 83.33%, there is not statistically significant (P>0.05)Conclusion:1. The function of reducing inflammatory reaction-. reducing platelet aggregation of Balanced Voluven is stronger than Albumin. The function of stabling hemodynamics, preventing blood concentration, protecting the liver and kidney of Balanced Voluven, which is similar to albumin.2. The pathogenesis of OHSS maybe related to the rise of IL-18. Balanced Voluven and Albumin maybe play a role by lowering the IL-18 content of early-onset and moderate and severe OHSS patients.3. During the treatment of Balanced Voluven and Albumin, before and after the liquid infusion of early-onset and moderate and severe OHSS patients, there is no difference. It can be inferred that Balanced Voluven expansion effect is similar to that of albumin.4. Due to the price of Balanced Voluven is lower than Albumin, and it is not blood product, it has no blood-borne infections, and it has almost no significant side effects, so it can replace the albumin for the treatment of early-onset and moderate and severe OHSS patients.