彩色多普勒评估多囊卵巢综合征二甲双胍治疗前后子宫和卵巢的血流变化  

Blood Flow Changes in the Uterus and Ovaries Before and After Metformin Treatment for Polycystic Ovary Syndrome Assessed with Colour Doppler

作　　者：金翠霞 房芳 叶征 王望明 JIN Cuixia;FANG Fang;YE Zheng;WANG Wangming(Maternal and Child Health Hospital of Xiaogan City,Xiaogan 432100,China;Xiaogang Central Health Center,Xiaogan 432100,China)

机构地区：[1]孝感市妇幼保健院,湖北孝感432100 [2]孝感市孝南区肖港中心卫生院,湖北孝感432100

出　　处：《湖北民族大学学报（医学版）》2024年第4期43-47,共5页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨多囊卵巢病(PCOD)卵巢彩色多普勒参数及血清激素指标,并评估多囊卵巢综合症(PCOS)患者二甲双胍治疗前后卵巢的彩色多普勒形态学和参数变化。方法选择2019年1月-2022年12月PCOD患者120例,其中96例为PCOS,24例为多囊卵巢形态(PCOM)。PCOD患者根据卵巢超声表现又分为外周囊性模式(PCP)及一般囊性模式(GCP)两组。记录所有患者血清卵泡刺激素(FSH)、黄体生成素(LH)、双侧卵巢体积、卵泡数目、间质回声及卵巢动脉RI、子宫动脉RI及PCOS患者二甲双胍治疗3个月后卵巢彩色多普勒参数及血清激素指标的变化情况。结果PCP患者的卵巢RI值低于一般囊性模式(GCP)(P<0.001)。PCOD患者LH和LH/FSH比值与卵巢间质RI之间存在显著相关性(r=0.403,r=0.654,P<0.01),LH值与卵巢动脉RI值呈负相关(r=0.403,P=0.009)。PCOS组卵巢平均体积、LH、LH/FSH比值高于PCOM组(P<0.05),FSH、卵巢动脉RI低于PCOM组(P<0.01)。PCOS患者卵巢动脉RI明显低于正常卵巢(P<0.001),子宫动脉RI高于正常卵巢(P<0.001)。PCOS患者二甲双胍治疗3个月后卵巢体积、LH、子宫动脉RI值、LH/FSH比值、FSH值均低于治疗前(P<0.05),卵巢动脉RI、FSH高于治疗前(P<0.05)。结论彩色多普勒超声是诊断PCOD的良好工具,有助于评估子宫卵巢循环小血管血流动力学变化和临床治疗疗效评估。Objective To investigate the ovarian color Doppler parameters and serum hormone indexes in polycystic ovary disease(PCOD)and evaluate the changes of color Doppler morphology and parameters of ovaries in patients with polycystic ovary syndrome(PCOS)before and after metformin treatment.Methods A total of 120 patients with PCOD were enrolled from January 2019 to December 2022,of which 96 were diagnosed with PCOS according to Rotterdam criteria,and 24 were diagnosed with PCOM.The changes in serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),bilateral ovarian volume,number of follicles,interstitial echo,ovarian artery RI,uterine artery RI,and metformin were recorded after three months of treatment.Results There was a significant correlation between LH and LH/FSH ratios and ovarian stromal RI in PCOD patients(r=0.403,r=0.654,P<0.01),and LH was negatively correlated with ovarian artery RI values.The RI value of ovarian artery in PCOS patients was significantly lower than that of normal ovaries,and the RI of uterine arteries was increased.The mean ovarian volume of the PCOS group was considerably higher than that of the PCOM group(P<0.05).The mean RI of the ovarian artery in the PCOS group was significantly lower than that of the PCOM group(P<0.01).There was no significant difference in the RI value of the uterine artery between the two groups(P>0.05).The LH and LH/FSH ratio in the PCOS group was significantly higher than that in the PCOM group(P<0.01).After three months of metformin treatment,the ovarian volume,LH,uterine artery RI,and LH/FSH ratio in the PCOS group were lower than before treatment,and the ovarian artery RI and FSH were higher than before treatment.Conclusion Color Doppler ultrasound is a good tool for diagnosing PCOD.Doppler helps evaluate the hemodynamic changes of small blood vessels in utero-ovarian circulation and evaluate clinical treatment efficacy.

关 键 词：多囊卵巢综合症 彩色多普勒 二甲双胍 子宫动脉RI 卵巢动脉RI 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.21[医药卫生—诊断学]