经阴道彩色多普勒超声对孕早期习惯性流产的子宫血流动力学变化研究

Study on the change of uterine hemodynamics of patients with habitual abortion during the first trimester of pregnancy by transvaginal color Doppler ultrasonography

目的:经阴道彩色多普勒超声观察早孕期各种习惯性流产的子宫动脉血流动力学变化,研究子宫动脉血流阻力指数(RI)值、搏动指数(PI)值与习惯性流产的关系。方法:经阴道彩色多普勒超声观察黄体功能不全引起的习惯性流产20例,黄体功能正常习惯性流产20例和正常群组20例各妊娠早期子宫动脉血流,对照统计各组子宫动脉RI值、PI值的相关关系及各组之间子宫动脉RI值、PI值的差异。结果:正常群组子宫动脉RI值、PI值下降,RI均值为0.792 0±0.024 4、PI均值为1.985 5±0.275 6。黄体功能正常组子宫动脉RI值、PI值增高16例,无变化或下降4例,RI均值为0.838 0±0.031 8、PI均值为2.503 5±0.268 6。黄体功能不全组子宫动脉RI值、PI值增高17例,无变化或下降3例,RI均值为0.839 0±0.032 5、PI均值为2.485 5±0.235 0。统计分析结果,正常组与黄体功能正常组、正常组与黄体功能不全组子宫动脉RI值、PI值差异有统计学意义(P<0.01),黄体功能正常组和黄体功能不全组子宫动脉RI值、PI值差异无统计学意义(P>0.05)。结论:各种原因引起的习惯性流产患者妊娠早期,无论是黄体功能不全或黄体功能正常,都可见子宫动脉RI值、PI值增高,子宫动脉RI值、PI值增高是习惯性流产发生过程中的一种病理表现,子宫动脉RI值、PI值增高是导致孕早期习惯性流产的主要发病因素。

Objective： To observe uterine hemodynamic changes of patients with habitual abortion during the first trimester of pregnancy by transvaginal color Doppler ultrasonography, and research the relationship between resistance index （ RI）, pulsatility index （PI） and habitual abortion. Methods： The blood flow situations of uterine artery during the first trimester of pregnancy in 20 cases with habitual abortion induced by luteal phase defect （luteal phase defect group）, 20 cases with habitual abortion and normal luteal function （normal luteal function group）, and 20 normal pregnant women （ normal control group）, the correlation between RI and PI of uterine artery and the differences of RI and PI in the three groups were analyzed statistically. Results ： RI and PI in normal control group decreased, the mean value of RI was （0. 792 0 ± 0. 024 4, ） , and the mean value of PI was （ 1. 985 5 ± 0. 275 6） . In normal luteal function group, PI and RI increased in 16 cases and decreased or had no change in 4 cases, the mean value of RI was （0. 838 0 ± 0. 031 8 ） , and the mean value of PI was （2. 503 5 ±0. 268 6） . In luteal phase defect group, PI and RI increased in 17 cases and decreased or had no change in 3 cases, the mean value of RI was （0. 839 0 ± 0. 032 5 ）, and the mean value of PI was （2. 485 5 ± 0. 232 5 ） . There was statistically significant difference in RI and PI between normal luteal function group and normal control group （P 〈 0. 01 ） , and there was statistically significant difference in RI and PI between luteal phase defect group and normal control group （P 〈 0. 01 ）, but there was no statistically significant difference in RI and PI between luteal phase defect group and normal luteal function group （ P 〉 0.05 ） . Conclusion： RI and PI of uterine artery increase in the patients with habitual abortion induced by different causes during the first trimester of pregnancy, which are pathological manifestations during the course of habitual abortion; RI and PI of uterine artery are major causes inducing habitual abortion during the first trimester of pregnancy.