卵巢早衰的血流变化特点及超声诊断的临床应用

Features of changes of blood flow in POF and the clinical application of ultrasound diagnosis

目的探讨卵巢早衰血流变化特点及超声诊断价值。方法 2014年2月至2015年6月确诊卵巢早衰患者30例(标记为试验组)及正常育龄妇女30例(标记为对照组),均接受阴道彩色多普勒超声检查,比较2组二维声像图及血流动力学指标,同时对2组对象性激素水平测定,Spearman相关分析卵巢早衰血流动力学指标与性激素水平关系。结果试验组与对照组在卵泡数、卵泡大小、内膜厚度、子宫体积、卵巢体积、卵巢结构、回声方面比较差异均有统计学意义(P<0.05)。试验组动脉舒张末期流速(EDV)、收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI)分别为(3.4±2.0)cm/s、(11.5±1.4)cm/s、(2.1±1.0)、(0.80±0.11),较对照组的(7.2±1.2)cm/s、(22.3±3.3)cm/s、(1.2±0.4)、(0.63±0.07)差异有统计学意义(P<0.01)。2组卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平比较差异有统计学意义(P<0.01)。Spearman相关分析卵巢早衰PSV与E2呈正相关,与FSH负相关(P<0.05)。结论卵巢早衰血流动力学呈现PSV、EDV下降,RI、PI上升特点,且PSV与FSH、E2显著相关,经阴道彩色多普勒超声检查通过对卵泡数、卵泡大小、卵巢动脉血流动力学指标等显示可辅助卵巢早衰诊断。

Objective To investigate the features of blood flow in premature ovarian failure （POF） and the value of ultrasound diagnosis. Methods Thirty cases of patients with confirmed POF （marked as the experimental group） and 30 normal women of childbearing age （marked as the control group） from February 2014 to June 2015 were selected and all accepted vaginal color Doppler ultrasound examination. The two-dimensional ultrasonograms and hemodynamic indicators were compared between the two groups. Meanwhile, the sex hormone levels in the 2 groups were determined. The correlation between hemodynamic indexes of POF and sex hormone levels was ana- lyzed by Spearman analysis. Results The differences in the number of follicles, follicular size, endometrial thick- ness, uterine volume, ovarian volume, ovarian structure and echo between the experimental group and the control group were statistically significant （ P 〈0.05）. EDV, PSV, PI and RI of the experimental group were （3.4±2.0）cm/s, （11.5±1.4）cm/s,（2. l±1.0）and（0.80±0. 11）, respectively. Compared with those of the control group [（7.2±1.2）cm/s,（22.3±3.3）cm/s,（1.2±0.4） ,（0.63±0.07）], the differences were statistically signif- icant （ P 〈0.01）. The differences in levels of FSH, LH and Ez between the 2 groups were significant （ P〈 0.01）. Spearman correlation analysis showed PSV of POF was positively correlated with E2 and negatively corre- lated with FSH（ P 〈0. 05）. Conclusion Hemodynamics of POF shows that PSV and EDV decrease while RI and PI increase. PSV is significantly correlated with FSH and E2. The number of follicles, follicular size and ovarian artery hemodynamic indexes displayed by transvaginal color Doppler ultrasound examination can help auxiliary di- agnosis of POF.