应用超声与激素测定观察卵泡发育、排卵及子宫内膜变化的初步研究

STUDY ON FOLLICLE GROWTH,OVULATION AND MORPHOLOGICAL CHANGES OF ENDOMETRIUM BY ULTRASONIC AND BIOCHEMICAL MEASUREMENTS

作者用超声检查和激素测定对16例妇女的16个自然排卵月经周期作连续观察,观察其排卵前后卵泡发育、排卵及子宫内膜的变化。结果发现,排卵前优势卵泡的平均直径为20mm,平均体积为3.0ml,增长速度为1.0～3.0mm/24h。排卵后子宫内膜迅速增厚,于排卵后第5～9天达最厚。结合排卵后B超的不同声像特点,作者将分泌期内膜分为分泌早期、中期及晚期,并对其意义和应用价值进行了讨论。作者还分析了上述过程与激素变化的关系。

Daily growth of the follicles beforeovulation and the changes of the endometri-um after ovulation were recorded in 16 spon-taneous menstrual cycles by the ultrasonicand biochemical measurements. The meandiameter of the dominant follicle was 20mmbefore ovulation, the mean volume 3.0 ml,and the growth rate of the follicles 1-3mm/24h. Ovulation occurred within 24 h ofthe luteintzing hormone peak and within 48hours of the blood estrogen peak. The factthat the blood progesterone levels werehigher on the day of the LH peak indicatedthat luteinization of the dominant follicleshad already occurred prior to ovulation. So-nographic criteria of the endometricai tissuewere obtained after the serial observation.According to the different sonographic ap-pearances, the secretory phase of the endo-metriai tissue was divided into the earlysecretory phase, the middle secretoryphase and the late secretory phase.The sonographic characterization of theendometrial tissue in the different phasesas well as the thickness of the endometriumduring the cycles were described.The cli-nical usefulness of the criteria of the dif-ferent phases was to evaluate the subsequentluteal function, and facilitate the clinicalmanagement of the infertile women. The study confirms that ultrasound canprovide a reliable measure in monitoringthe follicular growth and ovulation, andobserving the morphological changes of theendometrial tissue during the secretoryphase. Thus the in vivo differentiation ofthe endometrial tissue during the secretoryphase could be studied non-invasively bymeans of the ultrasound tissue characteri-zation.