经阴道超声血流参数联合血清Ghrelin水平检测对PCOS不孕症患者IVF-ET妊娠结局的预测价值  

Predictive Value of Transvaginal Ultrasound Blood Flow Parameters Combined with Serum Ghrelin Levels for the Pregnancy Outcome of IVF-ET in Infertile Patients with PCOS

作　　者：商艳浦 杨文杰 张亚非 Shang Yanpu;Yang Wenjie;Zhang Yafei(Ultrasound Diagnosis Department,Pingdingshan Reproductive Medicine Research Institute,Pingdingshan,Henan,467000,China)

机构地区：[1]平顶山市生殖医学研究所超声诊断科,河南平顶山467000 [2]平顶山市生殖医学研究所妇科,河南平顶山467000

出　　处：《黑龙江医学》2025年第7期838-841,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨经阴道超声血流参数联合血清生长激素释放肽(Ghrelin)水平对多囊卵巢综合征(PCOS)不孕症患者体外受精-胚胎移植技术(IVF-ET)妊娠结局的预测价值。方法:选取2020年6月—2023年12月样本医院收治的107例PCOS不孕症患者作为观察组,依照1∶1选例原则选取同期到院体检的107名健康体检者作为对照组。根据妊娠结局将观察组患者分为妊娠结局不良组(n=51)和妊娠结局良好组(n=56)。比较两组受试者、不同妊娠结局患者经阴道超声血流参数[动脉血管搏动指数(PI)、阻力指数(RI)、舒张末期流速(EDV)、峰值流速(PSV)]及血清Ghrelin水平,比较不同妊娠结局患者临床资料,分析妊娠结局的影响因素及各指标联合的预测价值。结果:观察组患者PI、EDV、PSV高于对照组,RI、血清Ghrelin水平低于对照组,差异均有统计学意义(t=7.996、13.532、15.080、43.034、14.603,P<0.001);妊娠结局不良组患者PI、EDV、PSV高于妊娠结局良好组,RI、窦卵泡数、优质胚胎数、获卵总数≥5个占比、Ghrelin水平低于妊娠结局良好组,差异均有统计学意义(t/χ^(2)=4.682、8.400、8.359、20.081、2.118、2.969、3.957、7.707,P<0.05);窦卵泡数、优质胚胎数、获卵总数、PI、RI、EDV、PSV、Ghrelin为妊娠结局的影响因素,差异有统计学意义(P<0.05);经阴道超声血流参数联合血清Ghrelin水平预测妊娠结局的曲线下面积(AUC)高于各指标单独检测,差异有统计学意义(P<0.05)。结论:经阴道超声血流参数、血清Ghrelin水平与PCOS及IVF-ET妊娠结局有关,联合检测可进一步提高预测价值。Objective:To investigate the predictive value of transvaginal ultrasound blood flow parameters combined with serum Ghrelin levels for the pregnancy outcome of infertile patients with polycystic ovary syndrome(PCOS)undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods:A retrospective study was conducted to select 107 patients with PCOS infertility from June 2020 to December 2023 as the observation group(n=51),and 107 healthy physical examination subjects from the same period as the control group(n=56).The blood flow parameters[arterial pulsatility index(PI),resistance index(RI),end diastolic velocity(EDV),peak systolic velocity(PSV)]of transvaginal ultrasound,serum Ghrelin levels,and clinical data were compared between the two groups and patients with different pregnancy outcomes 28 days after IVF-ET.The factors affecting pregnancy outcomes and the predictive value of various indicators were analyzed.Results:Compared with the control group,the observation group had higher PI,EDV and PSV,and lower RI and Ghrelin,with statistically significant differences(t=7.996,13.532,15.080,43.034,14.603;P<0.001).Compared with patients with good pregnancy outcomes,patients with poor pregnancy outcomes had higher PI,EDV,PSV,lower RI,sinus follicle count,high-quality embryo count,proportion of total number of retrieved eggs≥5,and lower Ghrelin,with statistically significant differences(t/χ^(2)=4.682,8.400,8.359,20.081,2.118,2.969,3.957,7.707;P<0.05).The number of antral follicles,the number of high-quality embryos,the total number of retrieved eggs,PI,RI,EDV,PSV,and Ghrelin were all factors that significantly affected pregnancy outcomes(P<0.05).The area under the curve(AUC)of the combined detection of transvaginal ultrasound blood flow parameters and serum Ghrelin levels for predicting pregnancy outcomes was higher than that of each individual parameter,with a statistically significant difference(P<0.05).Conclusion:Transvaginal ultrasound blood flow parameters and serum Ghrelin levels are associated with PCOS and IVF

关 键 词：多囊卵巢综合征 不孕症 IVF-ET 经阴道超声血流参数 GHRELIN 妊娠结局 

分 类 号：R445[医药卫生—影像医学与核医学]