子宫内膜容积及血管化参数与复发性流产的相关性研究  

Study on the correlation between endometrial volume,vascularization parameters and recurrent spontaneous abortion

作　　者：谭舒尹[1] 蒙达华[1] 吕华超[1] 黄婧[1] 王林琳[1] 李敏清[1] 

机构地区：[1]广西壮族自治区妇幼保健院,530002

出　　处：《中国妇幼保健》2015年第29期5006-5009,共4页Maternal and Child Health Care of China

基　　金：广西壮族自治区卫生厅自筹课题〔Z.2013264〕

摘　　要：目的探讨三维能量多普勒超声对复发性流产者妊娠结局预测价值。方法采用三维能量多普勒超声技术（3D—CPA）监测30例复发性流产者（研究组）和21例正常妊娠妇女（对照组）黄体中期（排卵后5～7d），子宫内膜厚度（二维阴道超声）、子宫内膜容积，并计算3个血流参数：血管化指数（VI）、血流指数（FI）、血管血流指数（VFI）。结果研究组的黄体期中期子宫内膜厚度薄于对照组，容积〈对照组，内膜血管化参数VI、FI、VFI低于对照组，差异均有统计学意义（P〈0．05）。黄体期子宫内膜厚度、子宫内膜容积、子宫内膜的VI、FI、VFI做为预测持续妊娠≥12周指标的ROC曲线下面积分别为0．681、0．876、0．770、0．720、0．879，子宫内膜厚度有较低预测准确度，子宫内膜容积、VI、FI、VFI有一定预测准确度，预测价值高于子宫内膜厚度。结论在评价子宫内膜容受性方面，三维能量多普勒超声测量子宫内膜容积及血管化参数较二维超声测量子宫内膜厚度更为全面及敏感。三维能量多普勒超声测量黄体中期的子宫内膜容积、VI、FI、VFI对复发性流产者妊娠结局有一定的预测作用。Objective To explore the predictive value of three-dimensional power Doppler ultrasound （3D-CPA） for pregnancy outcome of recurrent spontaneous abortion （RSA） patients. Methods 3D-CPA was used to monitor endmnetrial thicknesses （ two-dimen- sional transvaginal ultrasound） and endometrial volumes in 30 RSA patients （study group） and 21 normal pregnant women （control group） at midluteal phase （5-7 days after ovulation） ; three blood flow parameters were calculated, including vascularization index （VI）, flow in- dex （FI）, and vascularization flow index （VFI） . Results Endometrial thickness at midluteal phase in study group was thinner than that in control group, endometrial volume in study group was smaller than that in control group, VI, FI, and VFI in study group were lower than those in control group, there were statistically significant differences （ P〈0.05 ） . The areas under ROC curve of endometrial thickness, en- dometrial volume, VI, FI, and VFI at midluteal phase for predicting pregnancy≥12 weeks were 0. 681,0. 876, 0. 770, 0. 720, and 0. 879, respectively ; the predictive accuracy of endometrial thickness was low, the predictive accuracies of endometrial volume, VI, FI, and VFI at midluteal phase were higher than that of endometrial thickness. Conclusion To evaluate endometrial receptivity, measuring endometrial vol- ume and vascularization parameters by 3D-CPA is more comprehensive and sensitive compared with two-dimensional transvaginal ultra- sound. Measuring endometrial volume, VI, FI, and VFI by 3D-CPA at midluteal phase has a certain predictive effect for pregnancy outcome of RSA patients.

关 键 词：三维能量多普勒超声 复发性流产 子宫内膜容积 血管化指数 血流指数 血管血流指数 

分 类 号：R714.21[医药卫生—妇产科学]