月经过少的超声诊断相关因素

Study of the correlated factors of ultrasonography associated with hypomenorrhea

目的调查月经过少的相关因素,进一步探讨月经过少的超声表现。方法纳入月经过少患者53例,同期监测排卵健康育龄女性46例。采用最大似然估计对排卵当日各项超声指数进行Logistic逐步回归分析,筛选出月经过少的主要相关因素。对回归参数估计值采用Waldχ~2检验,对整个模型的拟合情况采用似然比检验,并用ROC曲线法评价Logistic回归模型的预报能力。结果月经过少与子宫内膜下血管数（OR=0.06,95%CI 0.01～0.35）、子宫内膜血流分型（OR=0.15,95%CI 0.02～0.90）、Salle评分（OR=0.19,95%CI 0.05～0.72）等因素相关。建立回归模型能很好地区分月经过少患者及正常人。结论月经过少可能与子宫内膜血流缺乏有关;多数月经过少患者存在子宫内膜容受性低下,为潜在的不孕症患者。

Objective To investigate the correlated factors associated with hypomenorrhea using transvaginal ultrasonography,and find the effective evaluation and prognostic indicators of hypomenorrhea.Methods There were 53 patients with hypomenorrhea enrolled in our study,46 healthy volunteers were compared as the control group.The likelihood ratio test was used to evaluate the fitting situation of ultrasonographic and Doppler parameters of the ovulation day to the whole model.The Waldχ~2 test was used to evaluate the estimated value of regression parameters.A receiver operating characteristic（ROC） curve was used to assess the performance of the Logistic model.P value of less than 0.05 was considered to be statistically different.Results Three independent variables were selected on the final step of Logistic regression analysis,number of endometrial vascular（OR =0.06,95%CI 0.01～0.35 ）,endometrial blood flow types（OR=0.15,95%CI 0.02～0.90） and Salle score（OR =0.19,95%CI 0.05～0.72）.The model could distinguish hypomenorrhea and normal women very well.Conclusion Hypomenorrhea might be related to lack of endometrial blood flow.Most patients of hypomenorrhea might in the condition of low endometrial receptivity and developed to infertility.