子宫内膜螺旋动脉血流参数与多囊卵巢综合征不孕症的关系及对体外受精-胚胎移植助孕妊娠结局的判断价值研究  

Relationship between endometrial spiral artery blood flow parameters and infertility of polycystic ovary syndrome and the value of evaluating pregnancy outcome assisted by in vitro fertilization and embryo transfer

作　　者：向玉[1] 杨惠林[1] 马英兰[1] 余晓燕[1] 武薇薇 XIANG Yu;YANG Hui-lin;MA Ying-lan(Reproductive Center,Qinghai Red Cross Hospital,Xining Qinghai 810000,China)

机构地区：[1]青海红十字医院生殖中心,青海西宁810000

出　　处：《临床和实验医学杂志》2023年第15期1643-1646,共4页Journal of Clinical and Experimental Medicine

基　　金：青海省科学技术厅科学技术成果项目(编号:9632021Y0579)。

摘　　要：目的分析子宫内膜螺旋动脉血流参数与多囊卵巢综合征不孕症的关系及对体外受精-胚胎移植助孕妊娠结局的判断价值。方法回顾性选取2019年1月至2022年10月青海红十字医院收治的40例多囊卵巢综合征不孕症患者作为观察组,另选同期的40名健康体检女性作为对照组。检测两组受试者的子宫内膜螺旋动脉血流参数[收缩期峰值血流速度(PSV)、舒张期峰值血流速度(EDV)、搏动指数(PI)、阻力指数(RI)、收缩期峰值血流速度/舒张期峰值血流速度(S/D)]及性激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇、睾酮、LH/FSH]水平,分析多囊卵巢综合征不孕症患者子宫内膜螺旋动脉血流参数与性激素的关系,观察体外受精-胚胎移植助孕妊娠结局(妊娠失败、妊娠成功),采用受试者工作特征(ROC)曲线下面积(AUC)评价子宫内膜螺旋动脉血流参数对妊娠失败的预测效能。结果观察组PSV、S/D分别为(8.23±2.47)cm/s、2.45±0.37,均小于对照组[(10.78±3.76)cm/s、3.41±0.68],PI、RI分别为0.72±0.26、1.24±0.35,均大于对照组(0.59±0.17、0.98±0.26),差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,PSV、PI、RI和S/D均是多囊卵巢综合征不孕症的独立影响因素(P<0.05)。观察组FSH水平为(5.56±0.67)U/L,低于对照组[(6.28±1.01)U/L],睾酮、LH/FSH水平分别为(1.12±0.15)pg/mL、1.47±0.51,均高于对照组[(0.26±0.03)pg/mL、1.26±0.23],差异均有统计学意义(P<0.05)。经Pearson相关性分析,多囊卵巢综合征不孕症患者子宫内膜螺旋动脉PI、RI均与FSH呈负相关(P<0.05),与睾酮、LH/FSH呈正相关(P<0.05);PSV、S/D均与FSH呈正相关(P<0.05),与睾酮、LH/FSH呈负相关(P<0.05)。经ROC曲线分析,子宫内膜螺旋动脉PSV、PI、RI联合S/D预测多囊卵巢综合征不孕症患者经体外受精-胚胎移植助孕妊娠失败的AUC为0.908。结论子宫内膜螺旋动脉血流参数与多囊卵巢综合征不孕症的关系Objective To analyze the relationship between endometrial spiral artery blood flow parameters and infertility of polycystic ovary syndrome(PCOS)and to evaluate the pregnancy outcome assisted by in vitro fertilization and embryo transfer.Methods A total of 40 infertility patients with polycystic ovary syndrome admitted to Qinghai Red Cross Hospital from January 2019 to October 2022 were selected as the observation group,and 40 healthy women in the same period were selected as the control group.Endometrial spiral artery blood flow parameters[peak systolic blood velocity(PSV),peak diastolic blood velocity(EDV),pulsatile index(PI),resistance index(RI),peak systolic blood velocity/peak diastolic blood velocity(S/D)]and sex hormone levels[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol,testosterone,LH/FSH]in two groups were detected.The relationship between endometrial spiral artery blood flow parameters and sex hormones in infertility patients with polycystic ovary syndrome were analyzed,and the pregnancy outcome(pregnancy failure,pregnancy success)assisted by IVF and embryo transfer were observed.The area under receiver operating characteristic curve(ROC)area under the curve(AUC)was used to evaluate the predictive efficacy of endometrial spiral artery flow parameters for pregnancy loss.Results PSV and S/D were(8.23±2.47)cm/s,2.45±0.37 in observation group,which were lower than those in the control group[(10.78±3.76)cm/s,3.41±0.68],PI and RI in observation group were 0.72±0.26,1.24±0.35,which were higher than those in control group(0.59±0.17,0.98±0.26),the differences were statistically significant(P<0.05).Multiple Logistic regression analysis showed that PSV,PI,RI and S/D were independent influencing factors for infertility of polycystic ovary syndrome(P<0.05).The level of FSH in the observation group was(5.56±0.67)U/L,which was lower than that in the control group[(6.28±1.01)U/L],the levels of testosterone and LH/FSH were(1.12±0.15)pg/mL and 1.47±0.51,respectively,which were higher th

关 键 词：多囊卵巢综合征 妊娠结局 不孕症 子宫内膜螺旋动脉 体外受精-胚胎移植 

分 类 号：R711.75[医药卫生—妇产科学] R711.6[医药卫生—临床医学]