超声对输卵管积水患者卵巢功能及子宫内膜容受性的评估价值

Assessment value of ultra- sound on ovarian function and endometrial receptivity for infertility patients with hydrosalpinx

目的探讨彩色多普勒对输卵管积水患者卵巢功能及子宫内膜容受性的评估价值。方法收集2012年5月至2014年5月自贡市第四人民医院就诊的女性不孕症患者临床资料121例,其中81例输卵管积水患者纳入积水组,40例因男方因素不孕者纳入对照组,观察分析患者卵巢及子宫各项超声指标,随访积水组患者治疗后妊娠情况。结果积水组卵巢容积,窦卵泡数,卵巢及子宫动脉搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、内膜厚度、子宫血流类型方面与对照组比较,差异均有统计学意义(P<0.05)。输卵管双侧积水患者卵巢PI、RI、卵巢基质血流收缩期峰值流速(peak systolic velocity,PSV)、以及子宫血流PI、RI等血流参数和单侧患者比较,差异均有统计学意义(P<0.05)。卵巢功能正常患者卵巢、子宫相关指标与卵巢功能下降患者比较,差异均有统计学意义(P<0.05)。子宫内膜血流分布类型与卵巢功能有弱的相关性,与子宫内膜厚度呈中度相关(P<0.05)。输卵管积水患者治疗后1年妊娠率22.2%(18/81),单侧积水患者妊娠率[44.9%(13/29)]高于双侧[9.6%(5/52)];妊娠与子宫内膜血流分布类型呈强相关,与输卵管积水(单侧/双侧)及子宫内膜厚度呈中度相关(P<0.05),与卵巢功能(正常/下降)相关性较弱(P>0.05)。结论输卵管积水影响患者卵巢、子宫供血,彩色多普勒可以观察患者卵巢及子宫内膜血流情况的改变,结合窦卵泡数、卵巢容积、子宫内膜厚度及子宫内膜血流分布类型等指标,可以评估患者卵巢功能及子宫内膜的容受性。

Objective To investigate the assessment value of color Doppler on ovarian function and endometrial receptivity for infertility patients with hydrosalpinx. Methods Clinical data of 121 cases of infertility patients in The Fourth People＇s Hospital of Zigong City from May 2012 to May 2014 were collected,81 patients with hydrosalpinx were selected into hydrosalpinx group and 40 patients with male infertility factors were selected into control group,the ultrasound indexes of ovarian and uterus were observed and analyzed,and pregnancy of hydrosalpinx group were followed up. Results The ovarian volume,the number of antral follicles,pulsatility index（ PI） and resistance index（ RI） of both ovarian and uterine,endometrial thickness,uterine blood flow type in hydrosalpinx group were significantly different from those in the control group（P〈0. 05）. Between the patients with unilateral hydrocephalus and bilateral one,the differences in the blood flow parameters such as PI,RI and peak systolic velocity（ PSV） of ovarian and RI,PI of uterine were significant（P〈0. 05）. The correlation indexes of ovary and uterus between patients with normal and fall ovarian function were significantly different（P〈0. 05）. The distribution type of endometrial blood flow was weakly correlated with ovarian function,and correlated moderately with the thickness of endometrium（P〈0. 05）. Patients＇ pregnancy rate of one year was 22. 2 %（ 18 /81）,pregnancy rate of unilateral hydronephrosis[44. 9 %（ 13 /29） ] was higher than that of bilateral [9. 6 %（ 5 /52） ]. Pregnancy showed strong correlation with the distribution types of uterine endometrial blood flow,and moderate correlation with hydrosalpinx（ unilateral or bilateral） and endometrial thickness（P〈0. 05）,however,the correlation with ovarian function（ normal /fall） was weak（P〈0. 05）. Conclusion Hydrosalpinx impacts blood supply of ovarian and uterine,the blood flow change of ovarian and endometrial can be observed by color Doppler ultrasound,by combining with indicators such as antral follicle number,ovarian volume,endometrial thickness and endometrial blood flow distribution type,color Doppler ultrasound can evaluate ovarian function and endometrial receptivity to provide reference for the prognosis of infertility patients.