子宫内膜下血流多参数与内异症不孕患者子宫内膜容受性的相关性研究

Correlation between Subendometrial Blood Flow Multiple Parameters and Endometrial Receptivity in Patients with Endometrial Infertility

目的:探讨子宫内膜下血流多参数与内异症不孕患者子宫内膜容受性的相关性。方法:选择2022年1月—2023年4月我院收治的50例内异症不孕患者纳入本研究观察组,另选择同期于我院进行身体检查的50名健康育龄女性纳入对照组。使用彩色多普勒超声检测子宫内膜厚度、PI、RI与SD等血流参数,根据检测结果计算并比较两组受检对象四项检查项目的差异;以检测结果为准绘制ROC曲线,明确四项指标单独检测与联合检测的最佳截断值、AUC;分析四项指标单独检测与联合检测对内异症不孕的诊断效能。结果:观察组子宫内膜厚度低于对照组,PI、RI与SD血流参数检测结果均高于对照组(P<0.05)。子宫内膜厚度、PI、RI与SD对内异症不孕均具有良好的诊断效能;多指标联合检测预测子宫内膜容受性与不孕症的曲线下面积AUC为0.909,优于四项指标单独检测(P<0.05)。子宫内膜厚度、PI、RI与SD联合检测诊断内异症不孕的灵敏度、特异度与准确率均高于四项指标单独检测(P<0.05)。结论:内异症不孕患者子宫内膜厚度明显降低,血流参数中PI、RI与SD明显增加,提示其子宫内膜容受性降低,通过对上述指标进行联合检测可预测内异症不孕患者患病风险,对后续干预方案的制定与实施有指导意义。

Objective:To investigate the correlation between multiple parameters of subendometrial blood flow and endometrial receptivity in patients with endometrial infertility.Methods:A total of 50 patients with endometrial infertility admitted to our hospital from January 2022 to April 2023 were included in the observation group,and 50 healthy women of childbearing age who underwent physical examination in our hospital during the same period were included in the control group.Blood flow parameters,such as endometrial thickness,PI,RI and SD,were detected by color Doppler ultrasound.The differences of four items between the two groups were calculated and compared according to the test results.The ROC curve was drawn based on the test results,and the best cutoff value and AUC of the four indexes were determined.To analyze the diagnostic efficiency of the four indexes alone and combined.Results:The endometrial thickness of observation group was lower than that of control group,and the blood flow parameters of PI,RI and SD were higher than those of control group(P<0.05).Endometrial thickness,PI,RI and SD all have good diagnostic efficacy.The AUC under the curve of endometrial receptivity and infertility predicted by multi-index combined detection was 0.909,which was better than that by four indexes alone detection(P<0.05).The sensitivity,specificity and accuracy of the combined detection of endometrial thickness,PI,RI and SD were higher than those of the four indexes alone(P<0.05).Conclusion:Endometrial thickness and PI,RI and SD increased significantly in blood flow parameters in patients with endometrial infertility,indicating that endometrial receptivity decreased.The combined detection of the above indicators can predict the risk of infertility in patients with endometrial infertility,which has guiding significance for the formulation and implementation of follow-up intervention programs.