经阴道彩色多普勒超声对不孕妇女子宫内膜及子宫动脉血流的研究

Study of Endometrial and Blood Flow of Uterine Artery in the Infertile Patients by Transvaginal Color Doppler Ultrasound

目的通过经阴道彩色多普勒超声（TVCDS）对不孕患者子宫超声图像和血流动力学表现进行分析,观察妇女内生殖器形态及血流动力学变化与患者不孕的关系,从而对该类疾病病因进行探讨,并为临床治疗提供信息.方法选择30例不孕患者作为观察组,30例月经正常的20~40岁健康育龄妇女作为对照组.应用TVCDS于增生期、分泌期分别进行检测：观测子宫内膜厚度,检测子宫动脉及分支血流动力学参数,并进行统计学分析.结果 1）不孕组患者和正常对照组人群的子宫内膜厚度差异无统计学意义（P〉0.05）;2）根据Gonen,Casper的分型标准：不孕组子宫内膜A型占26.67%,B型占30%,C型占43.33%;对照组子宫内膜A型占60%,B型占26.7%,C型占14.33%.组间比较,不孕症组的C型内膜比率明显高于对照组（P〈0.05）;3）不孕组的螺旋动脉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）.结论子宫内膜血流灌注减少可能是导致患者不孕的原因之一.TVCDS在评价子宫内膜形态及血流动力学变化具有明显优势,可为临床诊断提供线索和帮助,因此,可将TVCDS检查列为该类患者的常规检查项目.

Objective To analyze endometrial and blood flow of uterine artery in the infertile patients by transvaginal color doppler ultrasound,to investigate the relationship between morphological and hemodynamic changes of infertility patients by transvaginal color Doppler ultrasound（TVCDS）and to explore causes of this disease and to provide information for clinical treatment.Method 30 patients with infertility were selected as the observation group,and 30 healthy women of eumenorrhea aged 20 to 40 years were selected as control group.TVCDS in proliferative phase,secretary phase inspection was detected atrophy：observation of endometrial thickness;detection of uterine artery and its branch hemodynamic parameters were statistically analyzed.Results 1）Compared with normal control group,endometrial thickness showed no significant difference in infertility patients（P 0.05）.2）According to Gonen,Casper＇s classification criteria：endometrial type A in infertility group accounted for 26.67%,B-type 30%,C-type 43.33%;endometrial type A in control group accounted for 60%,B type accounted for 26.7%,C-type accounted for 14.3%.Compared with that in the control group,type C of endometria obviously increased in infertility group（P0.05）.3）RI,PI and S/D of spiral arteries in infertility group were higher than those in control group（P0.05）,but no significance in these parameters of uterine arteries,arcuate arteries and radiate arteries was found（P0.05）.Conclusion Reduction in blood supply of endometria may be one of the reasons leading to infertility patients.TVCDS has obvious advantages in the evaluation of endometrial morphology and hemodynamics,it can provide clues for the clinical diagnosis and help,it can be used as a conventional examination method for these patients.