生殖激素及超声检测PCOS合并不孕症临床意义

Clinical importance of reproductive hormone detection and transvaginal ultrasonography in diagnosing polycystic ovary syndrome with infertility

目的探讨阴道超声以及生殖激素检查对诊断多囊卵巢综合征(PCOS)合并不孕症的临床价值。方法选择2011年4月至2014年4月在松阳县妇幼保健所就诊的82例PCOS合并不孕症患者,对所有患者检测血清睾酮、促黄体激素(LH)、卵泡刺激素(FSH)等指标,行阴道超声诊断为卵巢多囊样改变,并分析生殖激素检测结果及超声检测结果。结果对82例患者的检测结果分析显示,阴道超声(59.76%)与高雄激素血症(13.41%)和LH/FSH>3(39.02%)的发生率相比差异均有统计学意义(x^2=21.975,P=0.000;x^2=8.336,P=0.009)。PCOS合并不孕患者相比正常女性,卵巢间质动脉舒张末期流速和卵巢间质动脉收缩期峰值流速更高,阻力指数和搏动指数更低,各指标对比差异均有统计学意义(t值分别为5.669、6.762、5.983、4.982,均P<0.05)。结论相比于生殖激素诊断PCOS合并不孕症,阴道超声诊断方式准确率更高,相对可靠。

Objective To evaluate the clinical importance of reproductive hormone detection and transvaginal ultrasonography in diagnosing polycystic ovary syndrome （PCOS） with infertility. Methods Totally 82 cases of PCOS with infertility were selected from Maternal and Child Health Care Hospital of Songyang County from April 2011 to April 2014, and serum levels of testosterone （T） , luteinizing hormone （LH） and follicle stimulating hormone （FSH） were detected. Transvaginal ultrasonography was performed to diagnose polycystic ovaries, and results were analyzed and compared. Results Coincidence rate of transvaginal ultrasonograph was 59.76% , that of hyperinsulinemia was 13.41% , and that of LH/FSH 〉 3 was 39.02%. There were statistical differences among them （X2 = 21. 975 ,P = 0. 000 ;X2 = 8. 336, P = 0. 009）. Compared with normal women, PCOS infertility patients had higher EDV and PSV but lower RI and PI. The differences among these indicators were significant （ t value was 5. 669, 6. 762, 5. 983 and 4. 982, respectively, all P 〈 0. 05 ）. Conclusion Transvaginal uhrasonography is a better method to diagnose PCOS complicated with infertility than reproductive hormones detection.