经阴道(直肠)超声检查对大学生多囊卵巢综合征患者诊断标准分析

Exploration of a diagnostic standard for trans-vaginal(rectal)ultrasound for polycystic ovary syndrome in college students

目的探讨应用经阴道(直肠)超声检查对某校大学生多囊卵巢综合征(PCOS)患者的诊断标准。方法在郑州大学医院2017年6月至2019年12月被诊断为PCOS的患者中,选取41例17~22岁的大学生患者为观察组;选取23~28岁的患者37例、29~34岁的患者30例、35~41岁的患者26例为对照组;另选取同期37名17~22岁月经规律的大学生作为健康对照组。在月经结束后3~5 d接受经阴道或经直肠超声检查,闭经者不限制检查时间。测量卵巢体积,记录卵泡数,比较17~22岁患者组与另3组患者及健康对照组各项指标;分别以卵巢体积和卵泡数为自变量、是否为PCOS为因变量,绘制17~22岁受试者工作特征(ROC)曲线,确定最佳截断值。结果17~22岁患者组、23~28岁患者组、29~34岁患者组、35~41岁患者组及健康对照组的卵巢体积分别为[(12.8±2.4)ml,(11.9±2.2)ml,(11.0±1.9)ml,(10.2±2.6)ml,(8.8±2.3)ml];5个组的卵泡数分别为[(14.0±2.9)个,(12.8±3.1)个,(11.9±2.9)个,(10.1±3.3)个,8.9±2.7)个]。观察组与另3组患者组及健康对照组比较,差异均具有统计学意义(P<0.05)。以卵巢体积为自变量、是否为PCOS为因变量,17~22岁患者组及健康对照组ROC曲线下面积为0.810,截断值为11.8 ml;以卵泡数为自变量、是否为PCOM为因变量,17~22岁患者组及健康对照组ROC曲线下面积为0.845,截断值为13个。结论经阴道(直肠)超声诊断某校大学生PCOS的标准,以卵巢体积>11.8 ml、卵泡数>13个较为可靠。

Objective To explore the diagnostic standard for trans-vaginal(rectal)ultrasound for poly-cystic ovary syndrome(PCOS)in college students.Methods From June 2017 to December 2019,41 college students with PCOS were selected from Zhengzhou University Hospital,who were 17-22 years old;37 patients aged 23-28 years,30 patients aged 29-34 years,and 26 patients aged 35-41 were selected for the control group.Thirty-seven college students with regular menses were selected as healthy subjects,who were aged between 17 and 23 years old.The subjects were examined at 3-5 days after menstruation or anytime during the amenorrhoea period.Ovarian volume and number of follicles were recorded and compared between the two groups.Using ovari-an volume and follicle number as test variables,and PCOS as the state variable,a receive operating character-istic(ROC)curve of subjects aged 17-22 years was drawn to determine the optimal cut-off value.Results The ovarian volumes of patients aged 17-22,23-28,29-34,and 35-41 years and subjects in the control group were[(12.8±2.4)ml,(11.9±2.2)ml,(11.0±1.9)ml,(10.2±2.6)ml,(8.8±2.3)ml],respectively.The number of follicles in the five groups were[(14.0±2.9),(12.8±3.1),(11.9±2.9),(10.1±3.3),(8.9±2.7)],respectively.There were statistically significant differences between the observation group and the other three groupsof pa-tients and the normal control group(P<0.05).With ovarian volume as the test variable and PCOS as the status variable,the area under the ROC curve of all receivers aged 17-22 years old was 0.810,and the value of cut-off was 11.8 ml.With the number of follicles as the test variable and PCOS as the status variable,the area under the ROC curve of all receivers aged 17-22 years old was 0.845,and the value of cut-off was 13.Conclusion For students at this certain university,it is appropriate to diagnose PCOS using a standard that indicates ovarian volume is more than 11.8 ml and the number of follicles is more than 13.