超声检查诊断多囊卵巢综合征价值的探讨

The Value of Ultrasonography on Diagnosis of PCOS

目的 :探讨超声检查在鉴别多囊卵巢综合征 (PCOS)与单纯卵巢多囊性改变 (PCO)中的意义及超声学参数与多囊卵巢综合征患者体内激素变化的相关性。方法 :将卵巢多囊性改变 14 4例按临床症状及内分泌检查分为多囊卵巢综合征 (PCOS)组与单纯卵巢多囊性改变 (PCO)组 ,分别测定其卵巢体积、卵巢面积、髓质面积及髓质面积 /卵巢总面积的比值 (S/TA) ,同时用化学发光酶联免疫法测定血清睾酮、雌二醇、黄体生成素、卵泡刺激素、血清泌乳素 ,并分析其与S/TA的相关性。结果 :①多囊卵巢综合征组卵巢体积、髓质面积、S/TA比值均显著高于卵巢多囊性改变组 (P均 <0 0 5 )。②S/TA比值与血清睾酮呈正相关 (P <0 0 5 )。③多囊卵巢综合征患者中S/TA比值较高组中肥胖人数较S/TA比值较低组中肥胖人数明显增多 (P <0 0 1)。结论 :①卵巢体积、S/TA比值在鉴别多囊卵巢综合征与单纯卵巢多囊性改变时具有较大价值。②S/TA比值可表示多囊卵巢综合征的严重程度 ,并推测可能与胰岛素抵抗和高胰岛素血症有关。

Objective: To study the value of ultrasonography in differential diagnosis of polycystic ovary syndrome (PCOS) and polycystic ovary (PCO), and to study the relationship between ultrasound parameters and endocrinological changes in PCOS. Methods: 144 cases of PCO diagnosed by ultrasonography were divided into two groups, PCOS group and PCO group, according to symptoms and endocrinological examinations. Ovarian volume, ovarian total area, ovarian stroma area and the stroma area /total area(S/TA)ratio were measured. The serum levels of testosterone, estradiol(E 2), luteinizing hormone(LH), Follicle stimulating hormone(FSH), prolactin(PRL) were assayed with chemical enzyme link immune light, and their relations to S/TA were analyzed. Results: ①In PCOS group, the mean ovarian volume, ovarian stroma area were significant larger and the S/TA was significantly higher than in PCO group ( P < 0.05 respectively). ②The S/TA ratio showed statistically significant positive correlation with the level of testosterone ( P <0.05). ③In PCOS patients, the prevalence of obesity in high S/TA ratio group was significantly higher than in the low S/TA group ( P <0.01). Conclusions: ①The ovarian volume and S/TA ratio were valuable in the differential diagnosis of PCOS and PCO. ②The S/TA ratio could evaluate the severity of PCOS. It also could be speculated that the S/TA ratio might be related with insulin resistant and hyperinsulinism.