三维超声测量子宫内膜容积及血流对黄体功能不全性不孕症价值  

Clinical value of three-dimensional ultrasonic measurement of endometrial volume and blood flow status in women with luteal phase defect infertility

作　　者：肖咸英[1] 何冠南[1] 彭卉[1] XIAO Xianying;HE Guannan;PENG Hui(Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan Province, 610000)

机构地区：[1]四川省妇幼保健院,成都610000

出　　处：《中国计划生育学杂志》2021年第9期1890-1893,1897,共5页Chinese Journal of Family Planning

摘　　要：目的:探究三维超声测量黄体功能不全性不孕症患者子宫内膜容积及血流情况的临床价值。选择2019年1月—2019年12月本院收治的黄体功能不全性不孕症患者40例为不孕组,同期体检健康女性40例为对照组。均行常规二维超声及三维超声检查,分析排卵期和黄体中期时两组超声测量参数:二维超声包括内膜厚度、子宫螺旋动脉血流的收缩期峰值流速(PSV)、搏动指数(PI)和阻力指数(RI),三维超声包括内膜容积、子宫内膜及内膜下血管指数(VI)、血流指数(FI)和血管血流指数(VFI)。结果:两组围排卵期、黄体中期子宫螺旋动脉PSV、PI和围排卵期的RI水平均无差异(P>0.05),不孕组黄体中期RI水平(1.01±0.09)高于对照组(0.93±0.14)(P<0.05);围排卵期子宫内膜容积和子宫内膜、内膜下的VI、FI、VFI水平两组无差异(P>0.05);黄体中期,不孕组子宫内膜容积(4.03±1.20ml)小于对照组(5.71±1.98ml),内膜下FI、VFI水平(24.98±3.22和2.30±0.56)低于对照组(29.31±3.74和2.91±0.99)(P<0.05)。相关性分析显示,不孕组黄体中期的子宫内膜容积与子宫内膜VI、FI、VFI及内膜下VI、FI、VFI正相关(均P<0.05);ROC曲线分析显示,黄体中期子宫螺旋动脉RI、子宫内膜容积、内膜下FI、内膜下VFI诊断黄体不全性不孕症的曲线下面积为0.706、0.761、0.800、0.697,诊断灵敏度和特异度分别为95.0%和50.0%、92.5%和60.0%、87.5%和62.5%、95.0%和42.5%。结论:三维超声能够评估黄体功能不全性不孕症患者子宫内膜容受性和血流情况,子宫内膜容积、内膜下FI有一定临床诊断价值。Objective:To explore the clinical significance of the endometrial volume and blood flow status of patients with luteal phase defect infertility analyzed by three-dimensional ultrasound.Methods:40 women with luteal phase defect infertility were selected in study group and 40 healthy women were selected in control group from January 2019 to December 2019.The women in both groups were examined by conventional two-dimensional ultrasound and three-dimensional ultrasound.The ultrasound measurement parameters during ovulation phase and mid-luteal phase of the women in the two groups were analyzed.The results by two-dimensional ultrasound included endometrial thickness,peak systolic velocity(PSV)of uterine spiral artery blood flow,pulsatility index(PI),and resistance index(RI),and the results by three-dimensional ultrasound included endometrial volume,and vascular index(VI),blood flow index(FI),and vascular blood flow index(VFI)of endometrium and subendometrium.Results:There were no significant differences in PSV and PI values of uterus spiral arteries in periovulatory and luteal mid phase,and RI value of uterus spiral arteries in periovulatory of the women between the two groups(P>0.05).The RI value of the women in the study group in luteal mid phase(1.01±0.09)was significant higher than that(0.93±0.14)the women in the control group(P<0.05).The endometrial volume,and the values of endometrial and subendometrial VI,FI,and VFI during ovulation of the women had no significant different between the two groups(P>0.05).In luteal mid phase,endometrial volume(4.03±1.20 ml)of the women in the study group was significant lower than that(5.71±1.98 ml)of the women in the control group,and subendometrial FI and VFI values(24.98±3.22 and 2.30±0.56)of the women in the study group were significant lower than those(29.31±3.74 and 2.91±0.99)of the women in the control group(P<0.05).Correlation analysis showed that endometrial volume of the women in the study group in luteal mid phase was positively correlated with their endometri

关 键 词：黄体功能不全性不孕症 子宫内膜容受性 三维超声 子宫内膜容积 血流 临床价值 

分 类 号：R711.6[医药卫生—妇产科学]