彩色多普勒超声参数与多囊卵巢综合征并高胰岛素血症大鼠的胰岛素敏感性指数及临床疗效的关系研究  

Relationships between color Doppler ultrasound parameters and insulin sensitivity index and clinical efficacy in rats with polycystic ovary syndrome complicated with hyperinsulinemia

作　　者：孙希贞 耿琳琳 陈娟 张蔚 孙德明 李楠 SUN Xizhen;GENG Linin;CHEN Juan;ZHANG Wei;SUN Deming;LI Nan(National Research Institute for Family Planning,Beijing 100081,China)

机构地区：[1]国家卫生健康委科学技术研究所,北京100081

出　　处：《中国比较医学杂志》2025年第3期82-89,共8页Chinese Journal of Comparative Medicine

基　　金：国家重点研发专项(022YFF0711001);中央级公益性科研院所基本科研业务专项资金面上项目(2023GJM04)。

摘　　要：目的 分析彩色多普勒超声参数与多囊卵巢综合征(polycystic ovary syndrome, PCOS)合并高胰岛素血症(hyperinsulinemia, HI)大鼠胰岛素敏感性指数(insulin sensitivity index, ISI)的评估价值。方法 选取140只3周龄SPF级SD雌性大鼠为研究对象,制备PCOS未合并HI大鼠模型(对照组70只)和PCOS合并HI大鼠模型(研究组70只),造模成功后,应用彩色多普勒超声检测大鼠卵巢的物理指标、血液动力学指标和超声表现特征,并抽取静脉血以评估ISI。而后给予研究组大鼠二甲双胍灌胃治疗,比较疗效良好组、疗效不佳组彩色多普勒超声参数,绘制受试者工作曲线(receiver operating characteristic curve, ROC),分析彩色多普勒超声参数对PCOS合并HI大鼠的疗效评估价值。结果 研究组卵巢总面积(total area, TA)、卵巢体积(ovarian volume, OV)、卵巢间质面积(interstitial are, SA)、血管化指数(vascularization index, VI)、血流指数(blood flow index, FI)、空腹胰岛素(fasting insulin, FINS)和空腹血糖(fasting blood glucose, FBG)均大于对照组,阻力指数(resistance index, RI)、搏动指数(pulsation index, PI)和ISI均小于对照组,差异有统计学意义(P<0.05)。研究组中TA、SA与ISI呈负相关(r=-0.501,r=-0.492,P<0.05),RI、PI与ISI呈正相关(r=0.504,r=0.485,P<0.05)。疗效良好组TA、OV、SA、VI、FI、VFI、PSV、PDV、低密度脂蛋白胆固醇、FPG、FINS、LH、FSH均小于疗效不佳组,RI、PI均大于疗效不佳组,差异有统计学意义(P<0.05)。ROC曲线分析显示,彩色多普勒超声参数联合评估临床疗效的灵敏度、特异度分别为90.9%、90.2%,曲线下面积(area under the curve, AUC)为0.901。结论 彩色多普勒超声参数与PCOS合并HI大鼠的ISI及临床疗效具有密切关系。Objective To analyze the relationships between color Doppler ultrasound parameters and insulin sensitivity index(ISI) and clinical efficacy in rats with polycystic ovary syndrome(PCOS) combined with hyperinsulinemia(HI). Methods A total of 140 3-week-old female SD SPF-grade rats were divided randomly into a PCOS without HI model(control group, n=70) and a PCOS combined with HI model(study group, n=70).After successful modeling, we used color Doppler ultrasound to detect the physical indicators, hemodynamic indicators, and ultrasound features of rat ovaries, and draw venous blood to evaluate ISI. Rats in the study group were treated with metformin by intragastric administration. The color Doppler ultrasound parameters of the good-effect and the poor-effect group were compared and a receiver operating characteristic curve(ROC) was drawn to analyze the value of the color Doppler ultrasound parameters for evaluating the curative effect of metformin in rats with PCOS combined with HI. Results The total ovarian area(TA), ovarian volume(OV), ovarian interstitial area(SA), vascularization index(VI), blood flow index(FI), fasting insulin(FINS), and fasting blood glucose(BFG) of the research group were all greater than those of the control group, while the resistance index, pulsatility index and ISI were observed significantly lower compared with contrast, there were obvious difference(P<0.05). The color Doppler ultrasound parameters TA and SA were negatively correlated with ISI(r=-0.501, r=-0.492, respectively, P<0.05), and ovarian RI and PI were positively correlated with ISI(r=0.504, r=0.485, respectively, P<0.05). TA, OV, SA, VI, FI, VFI, PSV, PDV, low-density lipoprotein cholesterol, FPG, FINS, LH, and FSH were all significantly lower while RI and PI were significantly higher in the good-curative-effect group compared with the poor-curative-effect group(all P<0.05). According to ROC curve analysis, the sensitivity and specificity of color Doppler ultrasound parameters combined with clinical efficacy were 90.9% and 90.

关 键 词：多囊卵巢综合征 高胰岛素血症 彩色多普勒超声 相关性 疗效评估 

分 类 号：R-33[医药卫生]