经阴道彩超对去氧孕烯炔雌醇片、炔雌醇环丙孕酮片治疗多囊卵巢综合征效果的评价作用

Value of transvaginal color Doppler ultrasound in evaluating the effects of desogestrel and ethinyl estradiol tablets and ethinyl estradiol and cyproterone tablets in the treatment of polycystic ovary syndrome

目的探讨经阴道彩超对去氧孕烯炔雌醇片、炔雌醇环丙孕酮片治疗多囊卵巢综合征效果的评价作用。方法抽取2017年6月至2019年6月于河南省职工医院接受治疗多囊卵巢综合征患者80例,按随机数字表法分为A组和B组。A组38例采用口服去氧孕烯炔雌醇片治疗,B组42例采用口服炔雌醇环丙孕酮片治疗。两组均行经阴道彩色多普勒超声检查。比较两组卵巢物理指标、卵巢动脉血流情况、性激素指标和痤疮评分、临床症状以及排卵和妊娠情况。结果治疗前A组与B组卵巢内卵泡数(FN)、卵巢体积(OV)、卵巢间质面积(SA)比较,差异未见统计学意义(P>0.05)。治疗后两组FN、OV和SA值较治疗前减小(P<0.05),治疗后两组间比较差异未见统计学意义(P>0.05)。治疗前A组与B组卵巢动脉舒张期末期血流速度(EDV)、收缩期峰值血流(PSV)、阻力指数(RI)以及搏动指数(PI)比较,差异未见统计学意义(P>0.05),治疗后两组EDV、PSV较治疗前下降,RI和PI较治疗前上升(P<0.05),治疗后两组间比较差异未见统计学意义(P>0.05)。治疗前A组和B组血清总睾酮(TT)、黄体生成素(LH)/卵泡刺激素(FSH)及痤疮评分比较,差异未见统计学意义(P>0.05),治疗后性激素指标和痤疮评分较治疗前下降(P<0.05),治疗后两组间比较差异未见统计学意义(P>0.05)。A、B组治疗后临床症状及排卵率和妊娠率率明显改善(P<0.05),但两组间比较差异未见统计学意义(P>0.05)。结论去氧孕烯炔雌醇片和炔雌醇环丙孕酮片对治疗多囊卵巢综合征均有较好疗效,利用彩色多普勒超声可以较直观观察多囊卵巢综合征患者宫腔病变改善情况。

Objective To explore the value of transvaginal color Doppler ultrasound in evaluating the effects of desogestrel and ethinyl estradiol tablets and ethinyl estradiol and cyproterone tablets in the treatment of polycystic ovary syndrome.Methods A sample of 80 cases of patients with polycystic ovary syndrome who received treatment from Henan Provincial General Hospital from June 2017 to June 2019 were divided into groups A and B according to a random number table.Thirty-eight cases in group A were treated with oral desogestrel ethinylestradiol tablets,while 42 cases in group B were treated with oral ethinylestradiol cyproterone tablets.The two groups were compared in terms of ovarian physical indexes,ovarian artery blood flow,sex hormones,acne scores,clinical symptoms,ovulation and pregnancy.Both groups underwent transvaginal color Doppler ultrasound examination.The ovarian physical indicators,ovarian artery blood flow,sex hormone indicators and acne score,clinical symptoms,ovulation and pregnancy were compared between the two groups.Results There was no significant difference in the number of follicles(FN),ovarian volume(OV),and ovarian interstitial area(SA)between group A and group B before treatment(P>0.05),after treatment,FN,OV and SA value of the two groups was lower than that before treatment(P<0.05),and there was no statistically significant difference between the two groups after treatment(P>0.05).Before treatment,there was no significant difference between group A and group B in ovarian artery end-diastolic blood flow velocity(EDV),peak systolic blood flow(PSV),resistance index(RI)and pulsatility index(PI),P>0.05,EDV and PSV of the two groups after treatment decreased compared with before treatment,and RI and PI increased compared with before treatment(P<0.05),there was no significant difference between the two groups after treatment(P>0.05).There was no significant difference in serum total testosterone(TT),luteinizing hormone(LH)/follicle stimulating hormone(FSH)and acne score between group A and group B before treatment(P>0.05),and sex hormone indicators and acne score decreased after treatment compared with before treatment(P<0.05),the difference between the two groups after treatment was not statistically significant(P>0.05).The clinical symptoms,ovulation rate and pregnancy rate of groups A and B were significantly improved after treatment(P<0.05),but the difference between the two groups was not statistically significant(P>0.05).Conclusions Desogestrel and ethinyl estradiol tablets and ethinyl estradiol and cyproterone tablets have a good effect on the treatment of polycystic ovary syndrome.Color Doppler ultrasound can be used to visually observe the improvement of uterin cavity lesions in patients with polycystic ovary syndrome.