卵巢超声指标联合LH、E2及T对多囊卵巢综合征患者不孕的诊断价值

Diagnostic value of ovarian ultrasound indexes combined with luteinizing hormone,estradiol,testosterone for infertility in patients with polycystic ovarian syndrome

目的研究卵巢超声指标联合性激素指标对多囊卵巢综合征(PCOS)患者不孕的诊断价值。方法选取2017年1月至2020年1月西安市人民医院收治的84例PCOS不孕患者作为观察组,另选取同期入院进行孕前检查的84例健康女性作为对照组。比较两组受检者的血清促黄体生成素(LH)、雌二醇(E2)、睾酮(T)以及各超声指标的差异,并采用受试者工作特征曲线(ROC)评价其对PCOS患者不孕的诊断价值。结果观察组患者的子宫内膜体积为(1.51±0.33)cm^(3),明显小于对照组的(3.24±0.92)cm^(3),且卵巢体积、卵泡体积、平均卵泡数量、血管化指数(VI)、血流指数(PI)以及血管化血流指数(VFI)明显大(高)于对照组,差异均有统计学意义(P<0.05);观察组患者的LH和T分别为(12.04±2.46)U/L、(7.94±2.21)nmol/L,明显高于对照组的(5.33±1.12)U/L、(2.30±0.57)nmol/L,E2为(113.52±31.22)pmol/L,明显低于对照组的(125.36±38.14)pmol/L,差异均有统计学意义(P<0.05);经ROC分析结果显示,VI诊断多囊卵巢综合征患者不孕的曲线下面积值(AUC)值为0.794,敏感性为88.57%,特异性为68.09%;卵巢超声指标和LH、E2及T联合诊断多囊卵巢综合征患者不孕的AUC值为0.866,敏感性为90.48%,特异性为79.76%。结论卵巢超声指标联合LH、E2及T对PCOS患者不孕有一定的诊断价值,其特异度和敏感度较高。

Objective To study the diagnostic value of ovarian ultrasound indexes combined with sex hormones for infertility in patients with polycystic ovarian syndrome(PCOS).Methods A total of 84 infertile patients with PCOS who were admitted to Xi'an People's Hospital between January 2017 and January 2020 were selected as the observation group.Meanwhile,84 healthy women who came to the hospital for pre-pregnancy physical examination during the same period were selected as the control group.The differences of serum luteinizing hormone(LH),estradiol(E2),testosterone(T),and each ultrasound index between the two groups were analyzed,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of these indicators for infertility in patients with PCOS.Results The endometrial volume of the observation group was(1.51±0.33)cm^(3),smaller than(3.24±0.92)cm^(3)in the control group.The ovarian volume,follicle volume,average number of follicles,vascularization index(VI),perfusion index(PI),and vascularization flow index(VFI)in the observation group were significantly larger/higher than those in the control group(P<0.05).The levels of LH and T in the observation group were(12.04±2.46)U/L and(7.94±2.21)nmol/L,significantly higher than(5.33±1.12)U/L and(2.30±0.57)nmol/L in the control group,and the level of E2 was(113.52±31.22)pmol/L,lower than(125.36±38.14)pmol/L in the control group,with statistically significant differences(P<0.05).ROC curve analysis found that the area under the curve(AUC)value of VI to diagnose infertility in patients with PCOS was the highest,which was 0.794.The sensitivity and specificity were 88.57%and 68.09%.The AUC value of combined diagnosis with ovarian ultrasound indexes,LH,E2,and T was 0.866,with sensitivity of 90.48%and specificity of 79.76%.Conclusion The combination of ovarian ultrasound indexes with LH,E2 and T can be used to diagnose infertility in patients with PCOS,with high specificity and sensitivity.