经阴道超声检查联合血清抗米勒管激素水平检测对多囊卵巢综合征的诊断价值

Diagnostic Value of Transvaginal Ultrasound Combined with Anti-Müllerian Hormone Determination in Serum in Patients with Polycystic Ovary Syndrome

目的探讨经阴道超声检查联合血清抗米勒管激素(AMH)水平检测对多囊卵巢综合征(PCOS)的诊断价值。方法选取2020年4月至2021年4月医院收治的63例PCOS患者作为PCOS组,另选取48名体检健康女性作为健康对照组,于月经周期第6~13天进行经阴道超声检查,并进行血清AMH水平检测,比较两组二维声像图参数、卵巢动脉血流动力学指标及血清AMH水平,分析经阴道超声检查、血清AMH水平检测及两者联合对PCOS的诊断价值。结果 PCOS组卵泡数目、卵巢体积及卵巢间质体积均大于健康对照组,差异有统计学意义(P<0.05);PCOS组卵巢动脉舒张末期峰值流速(EDV)及收缩期峰值流速(PSV)均大于健康对照组,搏动指数(PI)及阻力指数(RI)均小于健康对照组,差异有统计学意义(P<0.05);PCOS组血清AMH水平高于健康对照组,差异有统计学意义(P<0.05)。经阴道超声检查联合血清AMH水平检测诊断PCOS的灵敏度、特异度及阴性预测值均高于单独检测,且漏诊率低于单独检测,差异有统计学意义(P<0.05)。结论经阴道超声检查可清晰显示卵巢及其血流情况,联合血清AMH水平检测可提高对PCOS的诊断灵敏度、特异度及阴性预测值,为临床诊断该疾病提供较为可靠的依据。

Objective The diagnostic value of transvaginal ultrasound combined with anti-Müllerian hormone(AMH) determination in serum in patients with polycystic ovary syndrome(PCOS) was investigated. Methods 63 PCOS patients admitted to hospital from April 2020 to April 2021 were selected as the PCOS group and 48 healthy women confirmed by physical examination as the healthy control group. Vaginal ultrasound was performed on the 6th to 13th day of menstrual cycle and the level of AMH in serum were detected, too. The two-dimensional sonographic parameters, the indexes of ovarian artery hemodynamics and the AMH level in serum were compared between the two groups. The diagnostic value of vaginal ultrasound, AMH determination in serum and the combination of the two methods for PCOS were analyzed. Results The number of follicles, ovarian volume and ovarian stromal volume in the PCOS group were all larger than those in the healthy control group, with significant differences(P<0.05);The end diastolic velocity(EDV) of ovarian artery and peak systolic velocity(PSV) in the PCOS group were both larger than those in the healthy control group, while the pulsatility index(PI) and resistance index(RI) were both smaller than those in the healthy control group, with significant differences(P<0.05);The AMH level in serum in the PCOS group was higher than that in the healthy control group, with significant difference(P<0.05). The sensitivity,specificity and negative predictive value of vaginal ultrasound combined with AMH determination in serum in the diagnosis of PCOS were both higher than those of single inspection, while the missed diagnosis rate was lower, with significant differences(P<0.05). Conclusion Transvaginal ultrasound can clearly show the ovary and its blood flow, and when combined with AMH determination in serum, the sensitivity, specificity and negative predictive value can be improved for the diagnosis of PCOS, thus providing reliable references for clinical diagnosis of this disease.