三维超声联合抗苗勒氏激素水平评估子宫切除患者卵巢功能的临床价值

Clinical value of three-dimensional ultrasound combined with anti-Müllerian hormone level in evaluating ovarian function in patients after hysterectomy

目的探讨三维超声联合抗苗勒氏激素(AMH)水平评估子宫切除患者卵巢功能的临床价值。方法选取于我院行子宫切除术的患者198例(研究组)和同期行妇科检查的健康妇女100例(对照组),两组均行经阴道三维超声检查,获取卵巢体积(OV)、卵巢间质动脉收缩期峰值流速(PSV)、卵巢间质动脉血管化指数(VI);实验室检查获取卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)和AMH水平,比较对照组与研究组术前及术后1、3、12个月上述参数的差异。绘制受试者工作特征(ROC)曲线分析各参数单独及联合应用评估子宫切除患者卵巢功能的诊断效能。结果研究组术后1、3、12个月OV、PSV、VI均低于对照组及术前,差异均有统计学意义(均P<0.05);术后1、3、12个月OV比较差异均有统计学意义(均P<0.05);术后12个月PSV、VI均较术后1、3个月下降,差异均有统计学意义(均P<0.05)。研究组术后1、3、12个月FSH、AMH水平与对照组及术前比较差异均有统计学意义(均P<0.05);术后12个月E2水平低于对照组术前及术后1、3个月(均P<0.05);术后1、3、12个月AMH水平比较差异均有统计学意义(均P<0.05)。ROC曲线分析显示,OV、PSV、VI、AMH水平评估子宫切除患者卵巢功能的AUC分别为0.622、0.752、0.612、0.695,联合应用的AUC为0.821。结论三维超声联合AMH水平可用于评估对子宫切除患者卵巢功能。

Objective To explore the clinical value of three-dimensional ultrasound combined with anti-Müllerian hormone(AMH)level in evaluating ovarian function in patients after hysterectomy.Methods A total of 198 patients underwent hysterectomy in our hospital were enrolled as study group,while 100 healthy women underwent gynecological examination during the same period were enrolled as control group.All underwent examination of transvaginal three-dimensional ultrasound to obtain ovarian volume(OV),peak systolic velocity(PSV),vascularization index(VI)of ovarian stroma.The folliclestimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)and AMH level were obtained by laboratory examinations.The differences of above parameters were compared between study group and control group before and at 1,3 and 12 months after surgery.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of different parameters application alone and in combination in evaluating ovarian function in patients after hysterectomy.Results OV,PSV and VI at 1,3 and 12 months after surgery in study group were lower than those in control group and before surgery,there were significant differences(all P<0.05).There were significant differences in OV at 1,3 and 12 months after surgery(all P<0.05).PSV and VI at 12 months after surgery were lower than those at 1 and 3 months after surgery(all P<0.05).There were significant differences in FSH and AMH levels at 1,3 and 12 months after surgery in study group compared with control group and before surgery(all P<0.05).E2 level in study group at 12 months after surgery was lower than that in control group,before surgery and at 1 and 3 months after surgery(all P<0.05).There were significant differences in AMH level at 1,3 and 12 months after surgery(all P<0.05).ROC curves analysis showed that the area under the curve of OV,PSV,VI,AMH level and combined application for evaluating ovarian function in patients after hysterectomy were 0.622,0.752,0.612,0.695 and 0.821,respectively.Conclusion Three-dimensional ultrasound combined with AMH level can evaluate the ovarian function in patients after hysterectomy.