多模态超声评估多囊卵巢综合征患者子宫内膜容受性的临床价值

Clinical value of multimodal ultrasound in evaluating endometrial receptivity in patients with polycystic ovary syndrome

目的探讨多模态超声评估多囊卵巢综合征(PCOS)患者子宫内膜容受性的临床应用价值。方法选取我院收治的PCOS患者49例(观察组)和同期行孕前常规检查的健康妇女30例(对照组),二维超声获取两组子宫内膜厚度、回声分型、波动模式;彩色多普勒获取子宫内膜及内膜-肌层血流分型;三维超声获取子宫内膜容积、血管血流指数(VFI);计算并比较两组多模态超声评分的差异。观察组患者予以坤泰胶囊联合氯米芬治疗,比较治疗前后多模态超声评分的差异。结果观察组与对照组子宫内膜厚度评分、回声分型评分、波动模式评分、内膜及内膜-肌层血流分型评分、内膜容积评分及VFI评分比较差异均有统计学意义(均P<0.001);观察组和对照组多模态超声评分总分分别为(10.29±1.62)分、(14.97±1.35)分,两组比较差异有统计学意义(P<0.05)。观察组和对照组中子宫内膜容受性不良者分别为46例和2例,差异有统计学意义(χ^(2)=59.358,P<0.001)。治疗前后观察组子宫内膜厚度评分、回声分型评分、波动模式评分、内膜及内膜-肌层血流分型评分、容积评分及VFI评分比较差异均有统计学意义(均P<0.05);治疗前后观察组多模态超声评分总分分别为(10.29±1.62)分、(12.63±1.92)分,二者比较差异有统计学意义(P<0.05)。治疗后,观察组中子宫内膜容受性不良者24例,较治疗前减少,差异有统计学意义(χ^(2)=24.200,P<0.001)。结论多模态超声在评估PCOS患者子宫内膜容受性中具有较好的临床应用价值。

Objective To explore the clinical application value of multimodal ultrasound in evaluating endometrial receptivity in patients with polycystic ovary syndrome(PCOS).Methods Forty-nine patients with PCOS admitted to our hospital(observation group)and 30 healthy women who underwent routine pre-pregnancy examination during the same period(control group)were selected.Two-dimensional ultrasound was performed in both groups to obtain endometrial thickness,types of echo and fluctuation.Color Doppler was used to obtain endometrial and myometrial blood flow.Then,the endometrial volume and vascular flow index(VFI)were obtained by three-dimensional ultrasound.The difference of multimodal ultrasound score between the two groups was compared.The observation group was treated with Kuntai capsule combined with clomiphene,and the difference of multimodal ultrasound score before and after treatment was compared.Results There were significant differences in scores of endometrial thickness,types of echo,fluctuation,endometrial and myometrial blood flow,VFI between the observation group and the control group(all P<0.05).The total multimodal ultrasound score of the observation group and the control group were(10.29±1.62)points and(14.97±1.35)points,respectively,and the difference was statistically significant(P<0.05).There were 46 cases and 2 cases of poor endometrial receptivity in the observation group and the control group,respectively,and the difference was statistically significant(χ^(2)=59.358,P<0.001).There were significant differences in scores of endometrial thickness,types of echo,fluctuation,endometrium and myometrial blood flow,volume and VFI in the observation group before and after treatment(all P<0.05).The total multimodal ultrasound score of the observation group before and after treatment were(10.29±1.62)points and(12.63±1.92)points,respectively,and the difference was statistically significant(P<0.05).After treatment,there were 24 cases of poor endometrial receptivity in the observation group,and the proportion of poor endometrial receptivity decreased compared with that before treatment(χ^(2)=24.200,P<0.001).Conclusion Multimodal ultrasound has better clinical application value in evaluating endometrial receptivity of PCOS patients.