子宫及卵巢大小、子宫内膜厚度联合卵巢血流动力学在多囊卵巢综合征中的应用价值  

Application value of uterine and ovarian volume,endometrial thickness combined with ovarian hemodynamics in polycystic ovarian syndrome

作　　者：柯抒晨 许张晔[3] Ke Shuchen;Xu Zhangye(The Second Clinical College of Wenzhou Medical University,Zhejiang Wenzhou 325035,China;Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Wenzhou Medical University,Zhejiang Wenzhou 325000,China;Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Wenzhou Medical University,Zhejiang Wenzhou 325200,China)

机构地区：[1]温州医科大学第二临床学院,325035 [2]温州医科大学附属第三医院妇产科,325200 [3]温州医科大学附属第二医院妇产科,325000

出　　处：《中国医师进修杂志》2021年第6期558-563,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨子宫体积、卵巢体积(OV)、子宫内膜厚度(ET)联合卵巢血流动力学指标在多囊卵巢综合征(PCOS)中的应用价值。方法选取2017年10月至2019年10月在温州医科大学附属第三医院诊断为PCOS的患者53例作为观察组,另选取同期进行体检的健康育龄期女性53例作为对照组,并根据PCOS患者不同停经时间和促排卵治疗后是否排卵进行分组。经阴道彩色多普勒超声测量PCOS患者治疗前子宫体积、OV、ET、卵巢内收缩期峰值血流速度(PSV)、卵巢动脉阻力指数(RI)、卵巢动脉搏动指数(PI)以及治疗周期中注射绒促性素前后、排卵后7 d上述指标水平,并进行比较。结果观察组治疗前子宫体积、RI、PI均低于对照组[(30.28±11.37)cm3比(38.41±13.02)cm3、0.31±0.04比0.73±0.09、0.86±0.24比1.16±0.32],OV、ET、PSV均高于对照组[(15.04±3.06)cm3比(6.35±1.32)cm3、(1.32±0.41)mm比(0.64±0.16)mm、(12.27±2.83)cm/s比(9.37±1.53)cm/s],差异有统计学意义(P<0.05)。治疗前,不同停经天数的各组PCOS患者子宫体积、OV比较差异无统计学意义(P>0.05);停经10~15 d组、停经16~30 d组、停经31~90 d组、停经>90 d组患者ET和PSV随停经时间的延长逐渐增高,RI和PI随停经时间的延长逐渐降低,差异均有统计学意义(P<0.05)。促排卵治疗后,53例PCOS患者中,48例促排卵成功,5例促排卵失败。促排卵成功组患者在注射绒促性素日、黄体中期时,OV、ET、PSV低于同时期促排卵失败组,子宫体积、RI、PI高于同时期促排卵失败组,差异均有统计学意义(P<0.05)。注射绒促性素日,促排卵成功组ET、RI、PI均低于黄体中期,PSV高于黄体中期,差异均有统计学意义(P<0.05);受试者工作特征曲线分析结果显示,子宫体积、OV、ET、卵巢血流动力学指标联合检查PCOS的曲线下面积为0.897(95%CI 0.795~0.968)、灵敏度(95.0%)和特异度(80.2%)均高于单一检查(P<0.05)。结论子宫体积、OV、ET联合卵巢血流动Objective To explore the value of uterine volume,ovarian volume(OV),endometrial thickness(ET)combined with ovarian hemodynamics in polycystic ovarian syndrome(PCOS).Methods Fifty-three patients with PCOS diagnosed in the Third Affiliated Hospital of Wenzhou Medical University from October 2017 to October 2019 were selected as observation group and 53 healthy women of child bearing age who underwent physical examination at the same time were selected as control group.Patients with PCOS were divided into groups according to their different menopause times and ovalution statusafter ovulation promotion.The uterine volume,OV,ET,peak ovarian systolic velocity(PSV),ovarian artery resistance index(RI),and ovarian artery pulsation index(PI)was measured and recorded by transvaginal color Doppler ultrasound and compared between observation group and control group;and the above indicators in PCOS patients before and after chorionic gonadotrophin injection and 7 d after ovulation were compared.Results Before treatment,the value of uterine volume,RI and PI of the observation group were lower than those of the control group:(30.28±11.37)cm3 vs.(38.41±13.02)cm3,0.31±0.04 vs.0.73±0.09,0.86±0.24 vs.1.16±0.32,the OV,ET,and PSV were higher than those of the control group:(15.04±3.06)cm3 vs.(6.35±1.32)cm3,(1.32±0.41)mm vs.(0.64±0.16)mm,(12.27±2.83)cm/s vs.(9.37±1.53)cm/s,and the differences were statistically significant(P<0.05).Before treatment,the uterine volume and OV of PCOS patients had no significant differences in different menopause groups(P>0.05).In menopause 10-15 d group,menopause 16-30 d group,menopause 31-90 d group,and menopause>90 d group,the ET and PSV were gradually higher,the RI and PI were gradually lower,and the differences were statistically significant(P<0.05).After ovulation promotion among 53 PCOS patients,48 patients succeeded in ovulation promotion and 5 patients failed.On the day of chorionic gonadotrophin injection and mid luteal phase,the OV,ET and PSV in the successful ovulation induction gro

关 键 词：多囊卵巢综合征 经阴道彩色多普勒超声 卵巢血流动力学 应用价值 

分 类 号：R711.75[医药卫生—妇产科学]