经阴道超声对不同年龄卵巢多囊样改变的诊断价值分析  

Analysis of diagnostic value with transvaginal ultrasound on polycystic ovary morphology at different ages

作　　者：宋进 关怀 陈石 SONG Jin;GUAN Huai;CHEN Shi(Department of Special Diagnosis,No.967 Hospital of PLA,Liaoning,Dalian 116021,China;Department of Obstetrics and Gynecology,No.967 Hospital of PLA,Liaoning,Dalian 116021,China)

机构地区：[1]中国人民解放军联勤保障部队第九六七医院特诊科,辽宁大连116021 [2]中国人民解放军联勤保障部队第九六七医院妇产科,辽宁大连116021

出　　处：《发育医学电子杂志》2019年第4期287-291,共5页Journal of Developmental Medicine (Electronic Version)

基　　金：辽宁省自然科学基金（20180550166）;大连市医学科学研究计划项目(1712051)

摘　　要：目的探讨超声对不同年龄段卵巢多囊样改变(po1ycystic ovarian morphology,PCOM)的诊断价值。方法2015年1月至2018年5月,在中国人民解放军联勤保障部队第九六七医院优生优育门诊就诊的PCOS患者中,选取131例;同时选择有规律月经且无高雄激素血症的对照组女性135例。月经结束后3~5 d或闭经期行经阴道彩超检查,计算卵巢体积,计数卵巢卵泡数。以年龄将两组人群继续分组,分别为18~25岁(含25岁)、25~30岁(含30岁)、30~35岁(含35岁)、35~40岁(含40岁)、40~45岁。以卵巢体积或卵泡数为检验变量,以是否为PCOM为状态变量,绘制各年龄组受试者工作特征(receiver operator characteristic,ROC)曲线,确定最佳诊断分界点(约登指数最大,敏感度和特异度均最佳)。结果按18~25岁、25~30岁、30~35岁、35~40岁、40~45岁的顺序,PCOS组各年龄段卵巢体积分别为(13.5±3.7)、(12.0±3.0)、(12.1±3.5)、(11.3±2.9)和(10.8±3.0)ml,卵泡数分别为(15.3±3.8)、(15.7±4.3)、(13.2±4.8)、(12.7±4.5)和(11.1±3.7)个。每个年龄段,PCOS组的卵巢体积和卵泡数均大于对照组(P﹤0.05)。以卵巢体积为检验变量,以是否为PCOM为状态变量,按上述年龄顺序,ROC曲线下面积依次为0.764、0.737、0.809、0.834和0.763,截断值依次为13、10、9、9和9 ml。以卵泡数为检验变量,以是否为PCOM为状态变量,按上述年龄顺序,ROC曲线下面积依次为0.851、0.846、0.880、0.762和0.871,截断值依次为13、13、9、9和9个。结论用于诊断PCOM的卵巢体积和卵泡数阈值应随年龄而不同。18~25岁,卵巢体积13 ml且卵泡数13个;25~30岁,卵巢体积10 ml且卵泡数13个;30~45岁,卵巢体积9 ml且卵泡数9个。Objective To explore the diagnostic value of ultrasound for polycystic ovary morphology(PCOM)at different ages.Methods From January 2015 to May 2018,131 women with polycystic ovary syndrome(PCOS)were selected in the Department of Prepotency,No.967 Hospital of PLA.135 women with regular menses and no hyperandrogenism were selected as control group simultaneously.Ovarian volume and number of follicle were calculated and transvaginal ultrasound was performed at 3-5 day after menstruation or during the amenorrhoea period.Two groups were further divided into 5 subgroups as follow:18-25(containing 25),25-30(containing 30),30-35(containing 35),35-40(containing 40),40-45 based on their years old.A receiver operating characteristic(ROC)curve was constructed for working characteristics of the cases in all age groups to determine the optimum diagnostic cutoffs(the maximum value of Yoden index,the best sensitivity and specificity).The ovarian volume or follicle number was used as test variable,and whether to be PCOM as state variable.Results According to the age order of 18-25,25-30,30-35,35-40,40-45,the ovarian volume of PCOS in all age groups was as follow:(13.5±3.7),(12.0±3.0),(12.1±3.5),(11.3±2.9)and(10.8±3.0)ml respectively,meanwhile the follicle number was as follow:(15.3±3.8),(15.7±4.3),(13.2±4.8),(12.7±4.5)and(11.1±3.7)respectively.The PCOS group was larger than that in the control group in the ovarian volume and follicle number significantly in all age groups(P﹤0.05).Using the ovarian volume as test variable and whether to be PCOM as state variable,the area under the ROC curve was as follow:0.764,0.737,0.809,0.834 and 0.763,and the value of cutoff was as follow:13,10,9,9 and 9 ml respectively on the basis of age order.Using the follicle number as test variable and whether to be PCOM as state variable,the area under the curve was as follow:0.851,0.846,0.880,0.762 and 0.871,and the value of cutoff was as follow:13,13,9,9 and 9 respectively on the basis of age order.Conclusions The ovarian volume and follic

关 键 词：经阴道超声 多囊卵巢综合征 卵巢多囊样改变 约登指数 

分 类 号：R71[医药卫生—妇产科学]