多囊卵巢综合征患者的超声特征及其与内分泌指标间相关性分析  

Correlation between ultrasonic features and endocrine profiles in polycystic ovary syndrome patients with and without hyperandrogenism

作　　者：陈慧[1] 杨志芳[2] 詹维伟[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科,上海200025

出　　处：《诊断学理论与实践》2014年第2期171-175,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:比较多囊卵巢综合征(polycystic ovary syndrome,PCOS)伴与不伴高雄激素血症的患者超声特征及内分泌指标差异,并分析其间的相关性。方法:以睾酮≥1.08 ng/mL或游离睾酮≥3.18 pg/mL为标准,将126例PCOS患者分为PCOS伴高雄激素血症(hyperandrogenism,HA)(PCOS/HA组,34例)与PCOS不伴高雄激素(PCOS/NHA组,92例)。采用腔内超声检查测量并比较2组患者卵巢、子宫的灰阶及彩色多普勒二维超声参数;同时检测并比较2组患者的内分泌代谢指标,分析各超声参数与各内分泌代谢指标间的相关性。结果:PCOS/HA组患者的年龄明显小于PCOS/NHA组(P<0.05),而其卵巢体积、卵巢卵泡数、卵巢间质面积、卵巢间质面积与总面积之比、子宫动脉阻力指数均较PCOS/NHA组明显增高(P均<0.05),其卵巢间质动脉阻力指数则较PCOS/NHA组显著降低(P<0.01)。内分泌指标中,PCOS/HA组患者的睾酮、游离睾酮、硫酸脱氢表雄酮、雄烯二酮、三酰甘油、空腹血浆胰岛素均显著高于PCOS/NHA组(P均<0.05)。且PCOS/HA患者的卵巢卵泡数与其游离睾酮、糖化血红蛋白水平呈正相关(r分别为0.62、0.78,P均<0.01);其卵巢体积、子宫动脉阻力指数与其体质量指数呈正相关(r分别为0.64、0.57,P分别<0.01、<0.05);其卵巢间质动脉阻力指数则与体质量指数、性激素结合球蛋白、胰岛素抵抗指数、空腹血浆胰岛素水平相关(r分别为-0.46、0.55、-0.55、-0.57,P均<0.05)。结论:PCOS/HA组与PCOS/NHA组患者间的超声特征及内分泌指标有一定差异,且PCOS/HA组中这两者间有一定相关性。Objective： To observe the differences in ultrasonic features and endocrine indicators between polyeystic ovary syndrome （PCOS） patients with and without hyperandrogenism. Methods： One hundred and twenty-six patients with PCOS were recruited. Patients were subdivided into two groups according to the level of testosterone （T） or free-testosterone （FT）： group with hyperandrogenism （PCOS/HA, n=34, T≥ 1.08 ng/mL or FT≥3.18 pg/mL）; group without hyperandrogenism （PCOS/NHA, n=92, T〈1.08 ng/mL and FT〈3.18 pg/mL）. The ultrasonic parameters were analyzed and endocrine factors were determined. The correlations between ultrasonic features and endocrine profiles were analyzed. Results： Patients in PCOS/HA group were younger than those in PCOS/NHA group （P〈0.05）. Ovarian volume （vol） in PCOS/HA group was significantly higher than that in PCOS/NHA group （P〈0.01）, and the FN （follicle number）, SA （stromal area）, SA/TA （stromal area/ovarian total area） ratio and uterine artery RI （resistance index） were significantly higher （P〈0.05） and RI of ovarian interstitial artery was significantly lower in PCOS/HA group （P〈0.01）. The levels of T, FT, DHEA-S （dehydroepiandrosterone sulfate）, AD （androstendione）, G （glycerin trimyristate）, FINS （fasting plasma insulin） in PCOS/HA group were significantly higher than those in PCOS/NHA group （P〈0.01）. And in PCOS/HA group, FN was significantly associated with FF, HblAC （glycosylated hemoglobin） （r=0.62, 0.78, respectively, P〈0.01）. Vol and RI of uterine artery was significantly associated with BMI （r=0.64, 0.57, respectively, P〈0.05）. RI of ovarian interstitial artery was significantly associated with BMI, SHBG （sex hormone binding globulin）, HOMA-IR （homeostasis model assessment forinsulin resistance index） and FINS （r=-0.46, 0.55, -0.55, -0.57, respectively, P〈0.05）. Conclusions： Differences are seen in ultrasound and endocrine parameters between PCOS/HA and P

关 键 词：多囊卵巢综合征 高雄激素血症 内分泌指标 超声检查 

分 类 号：R588.6[医药卫生—内分泌]