多囊卵巢综合征患者血清血管内皮生长因子、内皮抑素水平及对卵巢间质血流的影响研究

Research of serum vascular endothelial growth factor and endostatin level and their effects on ovarian interstitial blood flow in patients with polycystic ovary syndrome

目的 探究多囊卵巢综合征患者血清血管内皮生长因子、内皮抑素水平变化及其对卵巢间质血流的影响。方法 选取我院2015年1月至2017年1月诊治的60例多囊卵巢综合征患者作为观察组，以同期在我院进行体检的健康生育期妇女60例作为对照组。观察两组研究对象血清血管内皮生长因子和内皮抑素的水平变化，同时对两组研究对象在卵泡早期应用经阴道彩色多普勒超声监测双侧卵巢间质血流的变化，对血流动力学指标（搏动指数和阻力指数）进行比较，分析血清血管内皮生长因子和内皮抑素水平对卵巢间质血流变化的影响。结果 观察组的搏动指数和阻力指数分别为1.3±0.2和0.5±0.1，对照组搏动指数和阻力指数分别为2.4±0.4和1.0±0.1，两组比较差异均有统计学意义（t值分别为2.378、2.578，P值分别为0.023、0.014）；观察组患者血清血管内皮生长因子和内皮抑素分别为（1 083±167）ng/L和（278±23）ng/L，对照组分别为（625±71）ng/L和（172±21）ng/L，两组比较差异均有统计学意义（t值分别为2.123、2.892，P值分别为0.042、0.008）。血管内皮生长因子与搏动指数和阻力指数均存在负相关（r值分别为－0.770和－0.782，P均〈0.01）；内皮抑素与搏动指数和阻力指数均存在负相关（r值分别为－0.751和－0.799，P均〈0.01）；血管内皮生长因子与内皮抑素呈正相关（r值为0.552，P〈0.01）。结论 多囊卵巢综合征患者血清血管内皮生长因子和内皮抑素显著增加，两者表达的失衡可能是造成卵巢间质血流增加的重要因素。

Objective To explore the changes of serum vascular endothelial growth factor （VEGF） and endostatin （ES） in patients with polycystic ovary syndrome （PCOS） and their effects on the ovarian stromal blood flow.Methods From January 2015 to January 2017, sixty cases diagnosed with polycystic ovary syndrome in the Eighth Affiliated Hospital of Sun Yat-sen University were selected into the observation group, and other 60 cases of healthy women with normal menstrual cycle in the same period were selected as the control group.Then, the levels of serum VEGF and ES of the two groups were observed, the patients in the early ovarian follicular blood flow changes were monitored by transvaginal color Doppler ultrasound to observe the bilateral ovaries and the hemodynamic indexes.Hemodynamic indexes （pulsatility index and resistance index） were compared, and the effects of serum VEGF and endostatin levels on ovarian interstitial blood flow were analyzed.Results The PI and RI of the observation group were（1.3±0.2） and （0.5±0.1）, the PI and RI of the control group were（2.4±0.4）and（1.0±0.1）, the differences were statistically significant（t=2.378, 2.578, P=0.023, 0.014）; the levels of VEGF and ES in the observation group were （1083±167）ng/L and （278±23）ng/L, the levels of VEGF and ES in the control group were （625±71） ng/L and （172±21）ng/L, the differences were statistically significant（t=2.123, 2.892, P=0.042, 0.008）; there was negative correlation among VEGF and PI and RI （r=-0.770, -0.782, P〈0.01）; there was negative correlation among ES and PI and RI （r=-0.751, -0.799, P〈0.01）; there was positive correlation between VEGF and ES （r=0.552, P〈0.01）.Conclusion The serum levels of VEGF and ES are significantly increase in patients with polycystic ovary syndrome, the imbalance between the two expressions may play an important role in the increase of ovarian stromal blood flow.