克氯米芬治疗不孕症对子宫内膜容受性影响的三维超声评价  

Assessment of endometrial receptivity by three-dimensional ultrasound in infertile women during treatment with clomiphene

作　　者：于姣姣[1] 张利华[1] 胡兵[2] 赵云[1] 

机构地区：[1]三峡大学医学院,湖北省宜昌市443000 [2]三峡大学第二临床医学院超声科

出　　处：《临床超声医学杂志》2017年第1期30-33,共4页Journal of Clinical Ultrasound in Medicine

基　　金：湖北省宜昌市科技研究与开发项目(A12301-48)

摘　　要：目的应用三维超声评价克氯米芬治疗不孕症对子宫内膜容受性的影响,探讨其对妊娠结局的影响。方法选取接受克氯米芬促排卵治疗的不孕患者46例,按妊娠结局分为妊娠组(17例)与非妊娠组(29例),分别于用药前后应用经阴道三维超声测量子宫内膜容积、厚度、子宫内膜及内膜下的血流分布类型、血管指数(VI)、血流指数(FI)、血管血流指数(VFI)、搏动指数(PI)、收缩峰速度与舒张末期速度比值(S/D)、阻力指数(RI)、收缩期峰值(PS)及舒张末期血流速度(ED),结果进行对比分析。结果两组患者用药前后子宫内膜厚度和容积比较差异均无统计学意义。用药前两组子宫内膜及内膜下血流相关参数比较差异均无统计学意义,用药后妊娠组RI、PI、ED、VI及VFI均降低,S/D、PS及FI升高,差异均有统计学意义(均P<0.05)。46例患者用药后子宫内膜及内膜下血流分布类型与用药前比较差异有统计学意义(P<0.05),A型血流内膜患者增多。结论克氯米芬促排卵治疗后对不孕症患者子宫内膜厚度和容积影响不大,克氯米芬治疗后子宫内膜及内膜下血流灌注状况改善的患者更有利于妊娠,三维超声检测血流参数可用于评价子宫内膜容受性并预测妊娠结局。Objective To evaluate endometrial receptivity by three-dimensional ultrasound in infertile women during treatment with clomiphene,and to explore effects of clomiphene on the outcome of pregnancy.Methods Forty-six infertile patients were collected from reproductive center treated with clomiphene,and divided into pregnant group（17 cases）and nonpregnant group（29 cases） according to the outcome of pregnancy. The endometrial volume,thickness,type,endometrial and subendometrial blood flow parameters（RI,PI,S/D,PS,ED,VI,FI,VFI） of two groups were detected by transvaginal three-dimensional ultrasound before and after treatment.Results There was no difference in endometrial volume and thickness before and after treatment between two groups.Before the treatment,endometrial and subendometrial blood flow parameters（RI,PI,S/D,PS,ED,VI,FI,VFI）had no difference between two groups.After the treatment,pregnant group had lower RI,PI,ED,VI,VFI and higher S/D,PS,FI of blood flow parameters,with statistical significant difference（all P 0.05）,the type of endometrial and subendometrial blood flow distribution had changed,patients in type A were increased.Conclusion Clomiphene has little effect on endometrial volume and thickness to infertile women,patients with good condition of endometrial and subendometrial blood flow perfusion are helpful to improve the pregnancy rate.The blood flow parameters measured by three-dimensional ultrasound can evaluate the receptivity of endometrium and predict the pregnancy outcome.

关 键 词：超声检查 三维 克氯米芬 不孕症 子宫内膜容受性 

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