应用彩色超声评价行体外受精-胚胎移植前脱氢表雄酮治疗卵巢储备功能低下患者的疗效  

Evaluation on efficacy of dehydroepiandrosterone for treatment of diminished ovarian reserve before in vitro fertilization and embryo transfer by color ultrasound

作　　者：袁华[1] 欧奇志[1] 李柳铭 马燕[1] 吴惠梅[1] 吴洪波[1] 

机构地区：[1]广西医科大学第一附属医院生殖医学研究中心,南宁市530021

出　　处：《广西医学》2016年第6期781-784,共4页Guangxi Medical Journal

基　　金：广西高校科学技术研究项目(KY2015YB066)

摘　　要：目的探讨卵巢储备功能低下(DOR)患者拟行体外受精-胚胎移植(IVF-ET)前使用脱氢表雄酮(DHEA)的治疗效果,以及应用经阴道彩色超声进行疗效评价的可行性。方法拟行IVF-ET的DOR患者122例,随机数字表法分为观察组和对照组各61例。观察组在IVF-ET前给予DHEA治疗,对照组在IVF-ET前给予淀粉安慰剂治疗。经阴道彩色超声测量两组治疗前后的基础窦卵泡数量及血流动力学参数,后者包括搏动指数、阻力指数、收缩期最大血流速度(PSV)、动脉血流收缩期峰值的流速/舒张期低值的流速(S/D)。结果在122例患者中,共110例完成试验,其中观察组56例,对照组54例。治疗前两组窦卵泡数量比较,差异无统计学意义(P>0.05)。治疗后观察组的窦卵泡数量明显多于治疗前(P<0.05),且明显多于对照组(P<0.05)。对照组治疗前后窦卵泡数量比较,差异无统计学意义(P>0.05)。治疗前两组患者的搏动指数、阻力指数、PSV、S/D比较,差异均无统计学意义(P>0.05)。治疗后观察组患者的搏动指数、阻力指数和S/D均明显低于治疗前(P<0.05),且明显低于对照组(P<0.05)。治疗后观察组PSV明显高于治疗前(P<0.05),且明显高于对照组(P<0.05)。治疗前后对照组搏动指数、阻力指数、PSV、S/D比较,差异均无统计学意义(P>0.05)。结论 DHEA能明显降低DOR患者的搏动指数、阻力指数和S/D,并显著提高窦卵泡数量和PSV;彩色超声操作简便,可重复性强,是一种评估DHEA治疗疗效的较好方法。Objective To explore the therapeutic efficacy of treatment with dehydroepiandrosterone（DHEA） before in vitro fertilization and embryo transfer （IVF-ET） for patients with diminished ovarian reserve （DOR）, and the feasibility of color ultrasound for efficacy evaluation. Methods A total of 122 patients with DOR who planned to receive IVF-ET were divided into observation group and control group according to the random number table,with 61 cases in each group. The observation group was treated with DHEA before IVF-ET,while the control group with starch placebo. Antral follicle count （ AFC ） and hemodynamic parameters including pulastility index （PI）, resistance index （RI）, peak systolic velocity（PSV） and minimum systolic and diastolic peak velocity ratio （S/D） were measured by transvaginal color ultrasound before and after treatment. Results Of 122 cases,110 finished the experiments including 56 in the observation group and 54 in the control group. There was no statistical significance in AFC between two groups before treatment（P 〉0.05）. After treatment,AFC of observation group was significantly more than AFC before treatment or AFC of control group （P 〈 0. 05 ）. There was no statistical difference between AFCs before and after treatment in the control group （P 〉 0. 05）. There were no statistical significances in PI, RI, PSV or S/D between two groups before treatment （ P 〉 O. 05 ）. After treatment,Pl, RI and S/D of observation group were significantly lower than those before treatment or those of control group （P 〈 0. 05 ）. PSV of observation group was significantly higher than those before treatment or those of control group（P 〈0. 05）. No significant change in PI,RI PSV or S/D was found in the control group after treatment （P 〉 0. 05 ）. Conclusion DHEA can significantly reduce PI, RI and S/D, and significantly elevate AFC and PSV in patients with DOR. Color ultrasound is easy and repeatable ,and is a good method for evaluating the therapeutic e

关 键 词：卵巢储备功能低下 彩色超声 经阴道 脱氢表雄酮 窦卵泡 血流动力学 

分 类 号：R711.75[医药卫生—妇产科学]