原因不明月经过少者经阴道彩色多普勒超声表现及分析

Transvaginal color Doppler ultrasound of patients with unexplained hypomenorrhe

目的观察月经过少与妇女内生殖器形态及血流动力学变化的关系,探讨其可能病因。方法选择原因不明月经过少患者30例,以月经正常的20~40岁健康育龄妇女30名作为对照组。应用经阴道彩色多普勒超声（TVCDS）于卵泡期、排卵期、黄体期及黄体萎缩期观测子宫、卵巢形态及大小;探测子宫、卵巢动脉及分支血流动力学参数,并进行统计学分析。同时于卵泡期、排卵期及黄体萎缩期化验月经过少患者性激素。结果①月经过少组患者的子宫大小、内膜厚度、卵巢大小、卵泡数与对照组比较差异无统计学意义（P〉0.05）。②月经过少组的C型内膜比率明显高于对照组（P〈0.05）。③月经过少组螺旋动脉RI、PI及S/D明显高于对照组（P〈0.05）;两组的子宫动脉、弓状动脉及放射动脉各血流参数比较差异无统计学意义（P〉0.05）,但月经过少组子宫动脉、弓状动脉、放射动脉及螺旋动脉RI均呈递减趋势。④月经过少组排卵期卵巢动脉RI、PI及S/D明显高于对照组（P〈0.05）。结论子宫内膜、卵巢血流灌注减少可能是导致原因不明月经过少的原因之一;TVCDS检查可列为月经过少患者的常规检查项目。

Objective To observe the relationship between morphological and hemodynamic changes of female internal genital organs in the patients with hypomenorrhea with transvaginal color Doppler ultrasound（TVCDS）.Methods Thirty female patients with hypomenorrhea of unknown origin were studied,and 30 healthy women of eumenorrhea aged 20 to 40 years were selected as control group.The size and shape of uterus,ovaries,and the thickness of endometria of uterus were observed with TVCDS in follicular phase,ovulation phase,luteal phase and luteal atrophy phase,respectively.Hemodynamic parameters of ovarian artery,uterus artery and their branches were measured.At the same time,hormones of female were examined in 30 patients in follicular phase,ovulation phase and luteal atrophy phase,respectively.Results ①No difference of the size of uterus and ovaries,the thickness of endometria and the amount of egg follicles was found between two groups（P〉0.05）.②Compared with that in the control group,type C of endometria increased in hypomenorrhea group（P〈0.05）.③RI,PI and S/D of spiral arteries in hypomenorrhea group were higher than those in control group,but no significance in these parameters of uterine arteries,arcuate arteries and radiate arteries was found.RI of uterine arteries,arcuate arteries and radiate arteries decreased successively.④RI,PI and S/D of ovarian arteries in hypomenorrhea group was higher than those in control group in ovulation phase（P〈0.05）.Conclusion Reduction in blood supply of ovary and endometria may be the causes of hypomenorrhea with unknown origin.TVCDS can be used as a conventional examination method for these patients.