肥胖型多囊卵巢综合征患者超声特征及其与内分泌指标的相关性  

Ultrasound characteristic and its correlation with endocrine profile in obese polycystic ovary syndrome patients

作　　者：陈慧[1] 杨志芳[2] 詹维伟[2] 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》2015年第2期159-163,共5页Journal of Diagnostics Concepts & Practice

基　　金：上海市科委浦江人才计划(11PJ1406600)

摘　　要：目的 :探讨肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的超声特征及其与内分泌指标间的相关性。方法:共纳入126例PCOS患者,以体质量指数(BMI)≥25 kg/m2诊断为肥胖,分为PCOS肥胖组(45例)和PCOS非肥胖组(81例)。经腔内超声测量患者的卵巢和子宫灰阶及彩色多普勒二维超声参数,并检测性激素及血脂等相关内分泌指标,进行2组间比较,分析各超声参数与内分泌指标间的相关性。结果:PCOS肥胖组与非肥胖组比较,肥胖组患者的卵巢卵泡数、卵巢体积、卵巢间质面积与总面积之比(stromal area/ovarian total area,SA/TA)、子宫动脉阻力指数(resistance index,RI)及游离睾酮、三酰甘油、胰岛素抵抗指数(the extent of insulin resistance and hyperandrogenism,HOMA-IR)、餐后2 h血糖、空腹血浆胰岛素、餐后2 h胰岛素、空腹血糖水平均明显增高(P均<0.05),而卵巢间质动脉RI、性激素结合球蛋白、高密度脂蛋白胆固醇则均明显降低(P均<0.05);非肥胖组的黄体生成素(luteinizing hormone,LH)和卵泡刺激素(follicle stimulating hormone,FSH)明显较高(P<0.05)。PCOS肥胖组中,卵泡数与BMI、LH/FSH呈正相关(r=0.31、0.46,P均<0.01),卵巢体积与BMI、空腹血糖、糖化血红蛋白、HOMA-IR、餐后2 h血糖呈正相关(r=0.44、0.50、0.79、0.44、0.39,P均<0.05),卵巢SA/TA与BMI呈正相关(r=0.37,P<0.01),子宫动脉RI与雄烯二酮呈正相关(r=0.52,P<0.05);而卵巢间质动脉RI与BMI呈负相关(r=-0.28,P<0.05)。PCOS非肥胖组中,卵泡数与LH/FSH呈正相关(r=0.38,P<0.05);卵巢体积与游离睾酮呈正相关(r=0.46,P<0.05)。结论:PCOS肥胖患者的超声参数具有一定特征性,且与内分泌指标间有一定相关性,而按BMI对患者进行分型,对评估其病情、发生代谢综合征风险及预防远期并发症有一定参考价值。Objective： To study the ultrasonic characteristic and its correlation with endocrine profile in obese polycystic ovary syndrome（PCOS） patients. Methods： One hundred and twenty-six patients with PCOS were recruited. Patients were categorized into PCOS with OB（OB-PCOS group, n=45） and without OB（NOB-PCOS group, n=81） groups according to body mass index（BMI）. Ultrasonic parameters and hormonal profiles were obtained and compared, and their correlations were analyzed. Results： Compared with NOB-PCOS group, BMI, FN（follicle number）,Vol（ovarian volume） and ratio of SA/TA（stromal area/ ovarian total area）, uterine artery RI（resistance index）, FT（free testosterone）, triglyceride（TG）, insulin resistance（HOMA-IR）, 2-h postprandial blood glucose（2h PG）, fasting plasma insulin（FINS）, 2-h postprandial plasma insulin（2h INS）, fasting blood glucose（FPG） of OB-PCOS group were significantly higher（P0.05）, but RI of ovarian interstitial artery, sex hormone binding globulin（SHBG）, high density lipoprotein（HDL）were significantly lower（P0.05）. Compared with OB-PCOS group, luteinizing hormone（LH）, follicular stimulating hormone（FSH） of NOB-PCOS group were significantly higher（P 0.05）. In OB-PCOS group, FN was correlated significantly with BMI, luteinizing hormone/follicular stimulating hormone（LH/FSH）（r =0.31, 0.46, P 0.01）. Vol was correlated significantly with BMI, FPG, glycosylated hemoglobin（Hb1AC）, HOMA-IR, and 2h PG（r=0.44, 0.50, 0.79, 0.44, 0.39, P0.05）; the ratio of SA/TA was correlated significantly with BMI（P0.01）. Uterine artery RI was correlated significantly with androstendione（AD）（r=0.52, P0.05）. RI of ovarian interstitial artery was correlated significantly with BMI（r=-0.28, P0.05）. In NOB-PCOS group, FN was correlated significantly with LH/FSH（r=0.38, P0.05）; Vol was correlated significantly with FT（r=0.46, P0.05）. Conclusions：There are certain ultrasonic characteristics in obese polyc

关 键 词：多囊卵巢综合征 肥胖 超声检查 内分泌指标 

分 类 号：R711.75[医药卫生—妇产科学]