伴或不伴胰岛素抵抗的多囊卵巢综合征的超声特征及其与内分泌指标的相关性  

Ultrasonic features and correlation with endocrine profiles in polycystic ovary syndrome patients with or without insulin resistance

作　　者：陈慧[1] 詹维伟[2] 杨志芳[2] 喇端端[1] 陈晨[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院妇产科,上海200025 [2]上海交通大学医学院附属瑞金医院超声影像科,上海200025

出　　处：《中国医学影像技术》2014年第4期595-599,共5页Chinese Journal of Medical Imaging Technology

基　　金：上海市科委浦江人才计划(11PJ1406600)

摘　　要：目的比较伴或不伴胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)患者的超声特征及其内分泌指标的相关性。方法根据胰岛素抵抗指数(HOMA-IR)将126例PCOS患者分为PCOS伴胰岛素抵抗组(IR-PCOS组,67例)和PCOS不伴胰岛素抵抗组(NIR-PCOS组,59例)。经腔内超声测量并比较两组卵巢和子宫灰阶及彩色多普勒超声参数;检测并比较两组性激素及血脂等相关内分泌指标;分析超声参数与内分泌指标间的相关性。结果 IR-PCOS组卵巢卵泡数(FN)、卵巢间质面积与总面积之比明显增高(P<0.05),卵巢体积、子宫动脉阻力指数(RI)显著增高(P<0.01),卵巢间质动脉RI降低(P<0.01),体质量指数(BMI)、游离睾酮增高(P<0.01),性激素结合球蛋白降低(P<0.05),甘油三酯、HOMA-IR、餐后2h血糖(2hPG)、空腹血浆胰岛素(FINS)、餐后2h血浆胰岛素显著增高(P<0.01),FPG增高(P<0.05),高密度脂蛋白降低(P<0.01)。IR-PCOS组FN与黄体生成素与卵泡刺激素比值呈正相关(P<0.01);卵巢体积与BMI、糖化血红蛋白、HOMA-IR、FPG、2hPG呈正相关(P<0.01);卵巢体积与FINS呈正相关(P<0.05)。结论 IR-PCOS与NIR-PCOS患者超声特征及内分泌指标有一定差异,且其间有一定相关性。Objective To observe ultrasonic features and differences of endocrine indicators in polycystic ovary syndrome （PCOS） patients with or without insulin resistance （IR）, and to investigate their correlation. Methods One hundred and twenty-six patients with PCOS were recruited. Patients were divided into PCOS with IR group （IR-PCOS group, n= 67） and without IR group （NIR-PCOS group, n=59） according to homeostasis model assessment for IR index （HOMA-IR）. Ultrasonic parameters andhormonal factors were obtained and compared, and their correlation was observed. Results Compared with NIR-PCOS group, follicle number （FN） and the ratio of stromal area/ovarian total area was significantly higher （P〈0.05）, the ovarian volume and uterine artery resistance index （RI） were also significantly higher （P〈0.01）, while RI of ovarian interstitial reduced （P〈0.01）, the levels of body mass index （BMI） and free testosterone were signifi- cantly higher （P〈0.01）, and sex hormone binding globulin was lower （P〈0. 05）, triglyceride, HOMA-IR, plasma glu- cose-2H （2hPG）, fasting plasma insulin （FINS）, plasma insulin-2 h were significantly higher （P（0.01）, fasting plasma glucose （FPG） was also higher （P〈0.05）, high density lipoprotein was significantly lower in IR-PCOS group （P〈0.01）. In IR-PCOS group, FN was significantly associated with luteinizing hormone/follicle stimulating hormone （P〈0.01）, the ovarian volume was significantly associated with BMI, glycosylated hemoglobin （HblAC）, HOMA-1R, FPG and 2hPG （P 〈0.01）, the ovarian volume was also significantly associated with FINS （P〈0. 05）. Conclusion There are differences in ultrasonic and endocrine parameters between IR-PCOS and NIR-PCOS patients, and correlation exist among them.

关 键 词：多囊卵巢综合征 胰岛素抵抗 超声检查 

分 类 号：R711.75[医药卫生—妇产科学] R445.1[医药卫生—临床医学]