目的 探讨人工周期冻融胚胎解冻移植（FET）的薄型子宫内膜患者采用粒细胞集落刺激因子联合他达拉非方案治疗的效果。 方法 采用前瞻性随机临床研究，选取2021年1月至2023年10月秦皇岛市第一医院生殖中心收治的行FET的薄型子宫内膜患者60例，其中30例患者给予他达拉非（对照组），另外30例患者在使用他达拉非的基础上加用粒细胞集落刺激因子治疗（研究组），对比两组患者治疗前后的超声检查子宫内膜声像特征、子宫动脉血流参数及两组的妊娠结局。 结果 研究组和对照组患者在接受治疗之前的子宫内膜厚度、子宫内膜容积测定结果进行比较，两组差异无统计学意义（P > 0.05）；治疗8、14 d后再次采用超声进行测定，子宫内膜厚度、子宫内膜容积的超声测定结果与接受治疗之前分别进行比较，两组差异有统计学意义（均P < 0.05）；研究组患者在接受治疗14 d后的子宫内膜厚度、子宫内膜容积测定值相对于对照组，两组差异有统计学意义（P < 0.05）；研究组和对照组患者在接受治疗之前的子宫内膜类型对比，两组差异无统计学意义（P > 0.05）；研究组在治疗14 d后，子宫内膜类型为A型的患者占比显著高于对照组（P < 0.05）；治疗前，研究组和对照组患者的PI、RI、S/D、VI、FI、VFI测定值比较，两组之间差异均无统计学意义（均P > 0.05）；14 d后，两组患者的VI、FI、VFI测定值与本组治疗之前比较均明显的增高（均P < 0.05），两组患者的PI、RI、S/D测定值与本组治疗之前比较均显著降低（均P < 0.05）；研究组在治疗14 d后的S/D测定值显著低于对照组，VFI测定结果明显高于对照组（P < 0.05）；两组患者的胚胎种植率、临床妊娠率、早期流产率、活产率差异无统计学意义（P > 0.05）。 结论 行FET的薄型子宫内膜患者采用粒细胞集落刺激因子联合他达拉非方案治疗较单纯使用他达那非能更好的改善子宫内膜容受性、血流灌注水平。

Objective To investigate the therapeutic efficacy of granulocyte colony-stimulating factor in combination with tadalafil in patients with thin endometrium undergoing artificial cycle frozen-thawed embryo transfer （FET）. Methods A prospective randomized clinical trial was conducted involving sixty patients with thin endometrium who underwent artificial cycle FET at the Reproductive Center of Qinhuangdao First Hospital between January 2021 and October 2023. The patients were randomly assigned to two groups： the control group （n = 30） received tadalafil， while the study group （n = 30） received granulocyte colony-stimulating factor in addition to tadalafil. Endometrial ultrasound characteristics， uterine artery blood flow parameters， and pregnancy outcomes were compared between the two groups before and after treatment. Results Before treatment， no significant differences were observed between the research group and the control group in terms of endometrial thickness or endometrial volume （P > 0.05）. Ultrasound assessments were repeated after 8 and 14 days of treatment. Compared with baseline measurements， both endometrial thickness and volume exhibited significant increases in both groups （all P < 0.05）. By day 14 post-treatment， the research group demonstrated significantly greater endometrial thickness and volume compared to the control group （P < 0.05）. With regard to endometrial patterns， no significant differences were noted between the two groups prior to treatment （P > 0.05）. After 14 days of treatment， the proportion of patients exhibiting a Type A endometrial pattern in the research group was significantly higher than that in the control group （P < 0.05）. Prior to treatment， no statistically significant differences were observed between the two groups in terms of pulsatility index （PI）， resistance index （RI）， systolic/diastolic ratio （S/D）， vascularization index （VI）， flow index （FI）， or Vascularization Flow Index （VFI） （all P > 0.05）. Following 14 days of treatment， both groups showed significant increases in VI， FI， and VFI compared to baseline values （all P < 0.05）， along with significant reductions in PI， RI， and S/D （all P < 0.05）. At 14 days post-treatment， the S/D ratio in the research group was significantly lower compared to the control group， while the VFI was significantly higher （P < 0.05）. However， statistical analysis showed no significant differences between the two groups in terms of embryo implantation rate， clinical pregnancy rate， early miscarriage rate， and live birth rate （P > 0.05）. Conclusion For patients with thin endometrium undergoing FET， the combination of granulocyte colony-stimulating factor and tadalafil is more effective than tadalafil alone in improving endometrial receptivity and uterine blood perfusion.