育龄期未生育PCOS患者子宫体体积与临床标志物的相关性分析

Volume of corpus uteri in nulliparous women of reproductive age with polycystic ovarian syndrome and its correlation with clinical indicators

目的分析育龄期未生育多囊卵巢综合征(PCOS)患者子宫体体积与代谢、内分泌、出凝血等指标及子宫动脉血流的相关性,为PCOS患者临床治疗和预后预测提供参考。方法选取2015年10月至2016年9月在上海交通大学医学院附属仁济医院就诊的育龄期未生育PCOS患者353例及正常未生育女性102例,超声检测子宫体大小及子宫动脉血流相关指数。PCOS患者按照子宫体大小的四分位间距分为子宫体体积偏小组、中间组及偏大组。检测PCOS患者的体质指数(BMI)、性激素、血糖及胰岛素等代谢及内分泌指标并进行相关性分析。结果育龄期未生育PCOS患者子宫体体积较正常女性偏小(Z=2.572,P<0.05),子宫动脉阻力指数(RI)、收缩期峰值速度/舒张末期血流速度(S/D)偏高(左:t值分别为2.961、3.531,均P<0.05;右:t值分别为2.413、2.804,均P<0.05)。子宫体体积偏小组、中间组及偏大组的患者年龄、黄体生成素、黄体生成素/卵泡刺激素(LH/FSH)比值、总胆固醇水平及子宫动脉血流阻力比较差异均有统计学意义(F值分别为6.898、6.483、7.228、4.742、3.054、5.142、4.454、4.542,均P<0.05)。结论子宫体体积偏小是育龄期未生育PCOS患者的主要临床表现之一,且与生殖内分泌紊乱程度、脂代谢异常及子宫动脉血流阻力升高相关。

Objective To analyze the correlation between volume of corpus uteri and metabolism,endocrine,bleeding and coagulation,and uterine artery blood flow in nulliparous women of reproductive age with polycystic ovary syndrome（ PCOS） so as to provide reference for clinical treatment and prognosis of PCOS patients. Methods A total of 353 nulliparous patients with PCOS and 102 nulliparous healthy women were collected in department of obstetrics and gynecology of Renji Hospital during October 2015 to September 2016. Volume of corpus uteri and uterine artery blood flow indexes were detected by ultrasound. PCOS patients were divided into 3 groups according to the lower and upper quartile of volume of corpus uteri： smaller volume group,middle volume group and larger volume group. BMI,sex hormones levels,blood glucose and other metabolic and endocrine indicators were collected for correlation analysis in patients with PCOS.Results Volume of corpus uteri in nulliparous PCOS patients was found to be smaller than that of women with normal menstruation cycle（ z = 2. 572,P 0. 05） and with higher uterine artery RI and S/D（ tL-RIvalue was 2. 961 and 3. 531,tR-RIvalue was 2. 413 and 2. 804,respectively,all P 0. 05）. The differences in patient＇s age,luteinizing hormone,LH/FSH ratio,total cholesterol level and uterine artery RI were statistically significant among three groups（ F value was 6. 898,6. 483,7. 228,4. 742,3. 054,5. 142,4. 454 and 4. 542,respectively,all P 0. 05）. Conclusion Smaller volume of corpus uteri is one of the remarkable clinical manifestations in nulliparous PCOS patients of reproductive age. It is likely related to the severity of reproductive-endocrine disorder,lipid metabolism disorders and increased uterine artery blood flow resistance.