Study on relationship between perifollicular blood flow and in vitro fertilization-embryo transfer

Objective：To study the relationship between perifollicular blood flow and follicule development, oocyte maturing rate, fertilizing rate, cleaving rate, embryo quality and the outcomes of embryo transfer. Methods： The samples were selected from 66 suffers who underwent in vitro fertilization（IVF）or intracytoplasmic sperm injection（ICSl）. Eeach patients＇ perifollicular blood flow（diameter ≥ 12mm ）was estimated on the day of human chorionic gonadotropin（HCG）administration. Results：Among 66 cycles, 26（39.4%） cycles resulted in pregnancy, perifollicular blood flow resistance index（Rl）, peak systolic velocity/end diastasis velocity（S/D） of non-pregnant group was significantly higher than that of the pregnant group （P 〈 0.004）. When RI 〈 0.49, the pregnancy rates, fecundation rates, fertilization rates, metaphase numbers for the of second meiosis oocytes increased evidently （P 〈 0.05）, but there were no statistical difference in gonadotropin dosage, cycle frequency, infertility years, ages, estradiol（E2）on the day of HCG administration, numbers of oocyet retrieved and high-quality embryo rates （P 〉 0.05 ）. There were no statistical difference between non-pregnant group and pregnant group in S and D （P 〉 0.05 ）. There was no correlation between periFollicular blood flow RI and follicular diameter by linear regression analysis. Conclusion：Our study shows that perifollicular blood flow RI and S/D are effective indices of predicting the pregnancy outcome of IVF-ET.

OCULAR BLOOD FLOW EVALUATION (POBF AND GDI) IN INJURED AND HEALTHY FELLOW EYES

Purpose: To assess if injured eyes develop ocular blood flow disturbances that may contribute to development of traumatic glaucoma. Materials and Methods: 25 patients hospitalized for eye injury and elevated IOP were evaluated 24 months after the trauma. All injured and fellow eyes underwent IOP measure, visual field (HFAII, Central 30/2SITA), pulsatile ocular blood flow analysis (POBF, OBF Labs UK), CDI examination (PSV, EDV, and RI) of Ophthalmic Artery, Central Retinal Artery, Short Posterior Ciliary Arteries. Results: IOP was significantly higher in injured eyes (15.1 vs 13.0±2.7mmHg) (P= 0,01), but only 2 eyes (8.8%) were under medical treatment POBF values were significantly lower in injured eyes: 11,25 μl/s in traumatised eyes and 15,40 μl/s in fellow eyes (P = 0.002). Resistivity Index (RI) of all investigated retrobulbar vessels was very significantly higher in injured eyes than in fellow eyes (P= 0.0001). There is no significant correlation between IOP and ocular blood flow disturbances.

加味调肝汤联合西药治疗肝郁肾虚型月经过少疗效及对患者子宫内膜厚度的影响

目的:研究加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效及对患者子宫内膜厚度的影响。方法:选取肝郁肾虚型月经过少患者共124例,采用随机数字表法分为观察组和对照组,其中对照组62例采用戊酸雌二醇(E2)、地屈孕酮治疗,观察组62例采用加味调肝汤联合戊酸雌二醇、地屈孕酮治疗。比较两组治疗效果、不良反应发生率,两组治疗前后中医证候积分、子宫内膜厚度、子宫血流阻力指数(RI)和卵泡期性激素水平。结果:观察组治疗总有效率为90.32%,较对照组总有效率75.81%高(P<0.05)。治疗前两组中医证候积分对比差异无统计学意义(P>0.05),治疗3个月后观察组上述积分较对照组更低(P<0.05)。治疗前两组卵泡期子宫内膜厚度、RI值比较,差异无统计学意义(P>0.05),治疗3个月后观察组卵泡期子宫内膜厚度较对照组更厚;RI较之于对照组更低(P<0.05)。治疗前两组卵泡期E2、FSH、LH水平比较无统计学差异(P>0.05);治疗3个月后观察组卵泡期性激素水平比对照组高(P<0.05)。观察组不良反应发生率为11.29%,与对照组的24.19%比较差异无统计学意义(P>0.05)。结论:加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效比单用西药治疗效果更佳,能促进子宫内膜生长,降低RI值,调节卵泡期性激素水平。

超声收缩期峰值血流速度、阻力指数与乳腺癌组织中Survivin、基质金属蛋白酶-11、人类表皮生长因子受体2关系研究

目的:探讨超声收缩期峰值血流速度(PSV)、阻力指数(RI)与乳腺癌组织中Survivin、基质金属蛋白酶-11(MMP-11)、人类表皮生长因子受体2(HER2)的关系。方法:选取60例乳腺癌患者作为观察组,另选择同期60例乳腺良性病变患者作为对照组。均行手术治疗,术前经超声检测,比较两组患者术前RI值、PSV值,免疫组化法检测术后癌组织中Survivin、MMP-11、HER2的表达,分析Survivin、MMP-11、HER2表达与超声RI、PSV值的关系。结果:观察组RI、PSV值高于对照组(均P<0.05)。观察组癌组织中Survivin、MMP-11、HER2表达阳性率高于对照组(均P<0.05)。不同病灶直径、临床分期患者RI、PSV值,不同病灶直径、临床分期及是否淋巴结转移患者癌组织中Survivin、MMP-11、HER2表达比较,差异有统计学意义(均P<0.05)。癌组织中Survivin、MMP-11、HER2表达与PSV、RI值呈正相关(均P<0.05)。结论:超声检测RI、PSV值对术前判断乳腺癌有一定价值,RI、PSV值与乳腺癌癌组织Survivin、MMP-11、HER2表达均相关,Survivin、MMP-11、HER2在乳腺癌的发生、发展过程中发挥重要作用。

CDFI与CT、MRI诊断妇科盆腔良恶性肿瘤的比较研究

本文对１２６例（１５２个病灶）经手术病理证实的妇科盆腔良恶性肿瘤进行ＣＤＦＩ检测，其诊断符合率为９２．１％，对良、恶性肿瘤数的检出率分别为９６．５％和８９．５％。按血流信号丰富程度分为Ｏ～Ⅲ级，良、恶性肿瘤分别以Ｏ、Ⅰ级和Ⅱ、Ⅲ级为主（Ｐ＜０．０１）；测定ＰＳ和ＲＩ值，良恶性肿瘤分别表现为中低速中低阻力频谱和高速低阻力频谱（Ｐ＜０．０１）。并与ＣＴ、ＭＲＩ比较，ＣＤＦＩ的准确性（８７．５％～９０．０％）和敏感性（７７．８％～８３．３％），明显高于ＣＴ，与ＭＲＩ相近。三种影像检测的特异性均在９２．９％～９３．３％之间，如联合检测可进一步提高诊断准确率。

超声血流参数、D-二聚体手术前后变化及复合模型在创伤骨折患者下肢DVT预警中的应用价值

目的探究超声血流参数[收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)]、D-二聚体手术前后变化及复合模型在创伤骨折患者下肢深静脉血栓形成(DVT)预警中的应用价值。方法选取2021年7月—2023年7月收治的创伤骨折200例,根据术后是否发生下肢DVT分为发生组25例与未发生组175例。收集2组基线资料及手术前后Vs、Vd、RI、D-二聚体数据,根据创伤骨折患者术后下肢DVT发生影响因素构建预测复合模型,评估Vs、Vd、RI、D-二聚体手术前后差值联合及复合模型对创伤骨折患者术后下肢DVT发生的预测价值。绘制决策曲线分析(DCA),分析超声血流参数、D-二聚体与复合模型预测创伤骨折患者术后下肢DVT发生的获益情况。结果发生组手术时间长于未发生组,术中使用止血带比例高于未发生组(P<0.01);发生组术后3 d Vs、Vd低于未发生组,RI、D-二聚体高于未发生组(P<0.01);发生组Vs、Vd、RI及D-二聚体手术前后差值均大于未发生组(P<0.01);多因素Logistic回归分析显示,手术时间、术中使用止血带及Vs、Vd、RI、D-二聚体手术前后差值为创伤骨折患者术后下肢DVT发生的独立危险因素(P<0.01);以Vs、Vd、RI、D-二聚体手术前后差值联合预测下肢DVT的曲线下面积(AUC)为0.882(95%CI:0.829,0.923),敏感度、特异度均为0.88。构建下肢DVT预测模型,其AUC为0.920(95%CI:0.873,0.954);DCA显示,复合模型在阈值概率为0.10~0.90时具有更高的临床价值。结论手术时间、术中使用止血带及Vs、Vd、RI、D-二聚体手术前后差值为创伤骨折患者术后下肢DVT发生的独立危险因素;与Vs、Vd、RI、D-二聚体手术前后差值相比,多指标联合建立的复合模型在创伤骨折术后下肢DVT早期预警中应用价值更高。

增强型体外反搏联合药物治疗视网膜中央动脉阻塞的疗效

目的探讨增强型体外反搏(EECP)联合药物治疗视网膜中央动脉阻塞(CRAO)的疗效。方法选择2020年5月—2021年5月我院诊治的视网膜中央动脉阻塞患者共48例(48眼)作为观察对象,根据治疗方法分为观察组22例(22眼)和对照组26例(26眼),另选取我院同期体检的健康人群20例(20眼)作为阴性对照组。观察组进行4个疗程的EECP联合药物治疗;对照组予单纯药物治疗;阴性对照组予单纯4个疗程EECP治疗。根据治疗前后患者视力、黄斑区血流密度、颈内动脉舒张期末血流速度(EDV)、收缩期峰值血流速度(PSV)及阻力指数(RI)等指标变化,评价及比较疗效。结果观察组总有效率高于对照组(χ^(2)=7.968,P<0.05)。观察组视力治疗后较治疗前显著提高,差异有统计学意义(P<0.05),对照组视力治疗后无明显提高,差异无统计学意义(P>0.05)。病程越短,EECP联合药物治疗效果越好,两者呈高度负相关(r=-0.837,P<0.05)。阴性对照组治疗后颈内动脉各项血流动力学指标较治疗前明显增加,治疗后RI较治疗前明显减小,差异有统计学意义(P<0.05);治疗后黄斑区血流密度各项指标较治疗前明显增加,差异有统计学意义(P<0.05)。观察组治疗后EDV与PSV较治疗前明显增加,治疗后RI较治疗前明显减小,差异有统计学意义(P<0.05)。对照组治疗前后EDV、PSV及RI均无明显改善,差异无统计学意义(P>0.05)。观察组治疗后黄斑区SCP与DCP血流密度较治疗前明显增加,差异均有统计学意义(P<0.05)。对照组治疗前后黄斑区SCP与DCP血流密度无明显变化,差异无统计学意义(P>0.05)。结论EECP联合药物治疗视网膜中央动脉阻塞,可显著提高CRAO患者的临床疗效,可在临床推广应用。

踝泵运动联合抗阻运动在老年糖尿病足患者康复中的应用效果分析

目的探讨踝泵运动联合抗阻运动在老年糖尿病足患者康复中的应用效果。方法选取2020年10月至2022年10月商丘市中医院收治的66例老年糖尿病足患者作为研究对象,按照不同治疗方法将其分为观察组(33例)与对照组(33例),观察组患者采用踝泵运动联合抗阻运动进行干预,对照组患者单纯采用抗阻运动进行干预,对比观察两组患者创面面积、踝肱指数(ABI)及足背动脉血流速度。结果干预1个月后,观察组患者创面面积为(3.45±1.32)cm^(2),明显小于对照组患者的创面面积(5.98±1.41)cm^(2)(t=7.525,P<0.001);观察组患者ABI为(1.18±0.12),明显大于对照组患者的ABI(0.93±0.11)(t=8.963,P<0.001);观察组患者足背动脉血流速度为(7.63±0.75)cm/s,明显快于对照组患者的足背动脉血流速度(6.38±0.42)cm/s(t=8.544,P<0.001)。结论与单纯应用抗阻运动相比,踝泵运动联合抗阻运动可明显改善老年糖尿病足患者的ABI,提高足背动脉血流速度,促进创面愈合。

Diagnostic value of different color ultrasound diagnostic method in endometrial lesions

BACKGROUND Endometrial lesions include endometrial cancer and inferior fibroids.Among them,endometrial cancer as a malignant tumor seriously endangers the life and health of patients.Ultrasonography is an important means of diagnosing female reproductive system diseases,and it is of critical value for the early diagnosis of endometrial cancer.However,different ultrasound inspection programs have achieved different results.It is of great significance to choose a suitable inspection program.AIM To explore the diagnostic efficacy of different ultrasonic examination methods in clinical endometrial lesions.METHODS The 140 patients with endometrial lesions who were treated in our hospital from April 2018 to October 2019 were used as the research subjects.All patients underwent transvaginal color ultrasound and transabdominal color ultrasound.We compared the diagnostic coincidence and image display effects of the two different examination methods,and the endometrial thickness,blood flow,uterine effusion and resistance index of different diseases were observed by transvaginal color ultrasound.RESULTS The diagnostic coincidence rate of all types of diseases of transvaginal color ultrasound was significantly higher than that of transabdominal color ultrasound(P=0.001,0.005,0.001 and 0.001).In addition,the excellent and good rate of image display of transvaginal color ultrasound was higher than that of transabdominal color ultrasound(P=0.001).There were significant differences in endometrial thickness in patients with different types of endometrial lesions through the transvaginal color examination(P=0.001).The incidence rate of uterine effusion in patients with endometrial carcinoma was significantly higher than that in patients with other types of endometrial lesions(P=0.001),and the rate of the blood flow was the highest(P=0.001).The comparison of blood flow resistance index indicated that the blood flow resistance index in endometrial cancer patients was the lowest,which shows that the difference was statistically significant(P=0.001).CONCLUSION The overall diagnostic efficacy of transvaginal color ultrasound in the clinical diagnosis of endometrial lesions is better than that of transabdominal color ultrasound,which held higher diagnostic coincidence rate and image display effect.There were significant differences in the thickness of the endometrium and the blood flow in different types of lesions.

经阴彩超宫颈癌RI值与其临床病理特征相关性分析

目的探讨经阴彩超检查宫颈癌的血流阻力指数(RI)与临床病理特征的关系。方法收集59例经病理证实为宫颈癌患者和50例经过经阴彩色多普勒检查的宫颈肌瘤患者,比较二者的血流及RI值,根据RI分组:RI <0. 5组、0. 5≤RI≤0. 8组与RI> 0. 8组,分析RI值与宫颈癌临床病理特征的关系。结果宫颈癌RI值明显低于宫颈肌瘤,差异具有统计学意义(P <0. 05); RI <0. 5组、0. 5≤RI≤0. 8组、RI> 0. 8组在FIGO分期、肿瘤直径、病理分级、淋巴结转移、肌层/宫旁浸润方面比较具有有统计学意义(P <0. 05); RI的AUC为0. 564(95%CI:0. 345～0. 824),当Youden指数最大值为0. 723时,对应的RI值为0. 61,将该值作为截断点,敏感性、特异性分别为80. 3%、82. 6%。结论 RI值变化与宫颈癌临床病理特征密切相关,FIGO分期越高、肿瘤直径越大、分化越低、有淋巴结转移及肌层/宫旁浸润的患者RI值越低;检测RI值对宫颈癌的诊断及判断肿瘤的恶性程度、浸润、转移情况具有重要的参考意义。

COLOR FLOW IMAGING OF HEPATIC CARCINOMA

Color flow imaging(CFI)ultrasound technique can discover the tumor vascularity and superimposed it to convontional B-mode ultrasonogram in real-time. The flow velocity on spectral Doppler sonogram can be measured by setting the sample volume to any selected site.One hundred and thirty-six patients with solid hepatic space-occupied lesions had been admitted and 113 cases were confirmed by operation and pathology,23 patients were strongly suspected by hepatic angiography (HAA).Ninety nine patients with 109 nodules were finally diagnosed as hepatic cellular carcinoma(HCC).According to color flow distribution pattern,3 kinds of color configuation had been nominated.Tumor vascularity discovered by CFI,especially the arterial blood flow was easy to be recognized,and its emerge rate was quite different between HCC group(94.5%)and hemangioma(HCH)group(17.07%)(P<0.01).Spectral Doppler studies were also carried out in these cases and the detectability of arterial flow in HCC group(95.41%)was much higher than that to HCH group (21. 95%) (P<0. 005).Resistant index(RI)and pulsatile index(PI)could be used to differentiate HCC (>0. 50 and >0.80 respectively)from HCH (P<0.001 and P<0.001 respectively).Arterial-portal(A-P) shunt could also be detected by CFI and spectral Doppler(mostly its Vmax>0.6m/s).The detection rate of A-P shunt was 64% in HCC group,but no case could be detected in HCH group.

Testicular vascularization at two locations in relation to hormonal levels,and pixel echotexture in bulls at different ages

Objective:To assess the hemodynamic changes that occurred in the main testicular artery at two different locations such as supra and marginal ones in bulls at three different ages.Methods:Eighteen Baladi bulls were divided according to their age into three different age groups:1 year[n=6;groupⅠwith bodyweight(380±10)kg],3 years[n=6;groupⅡwith bodyweight(570±10)kg],and 6 years old[n=6;groupⅢwith bodyweight(650±10)kg]Baladi bulls.Circumference of the scrotum,thickness of the mediastinum,testicular dimensions,vascularity,and hormonal levels were measured.Testicular hemodynamics were assessed by Doppler ultrasound scanning.Results:Testicular width,length,and volume were significantly different among the three age groups,with the highest in bulls of groupⅢ(P<0.05).The bulls in groupⅢhad significantly higher mediastinal line thickness and scrotal circumference than groupⅠ(P<0.05),but there was no significant difference between groupⅡand groupⅢ.Bulls in groupⅡshowed a decline in Doppler indices(resistance and pulsatility indexes)at both testicular branches compared to the other two groups(P<0.05).Supra and marginal end diastolic velocities in the three age groups were significantly different,with the highest in groupⅡ(P<0.05).Time average velocity(cm/s)was significantly elevated in groupⅡcompared to the other two groups(P<0.05).Both testicular echotextures were significantly decreased in groupⅡ(P<0.05).Estradiol and nitric oxide metabolites were significantly high in groupⅡcompared to the other two groups(P<0.05).Meanwhile,the level of plasma testosterone was maximum in groupⅢ(P<0.05).Positive correlations were found between supratesticular artery resistance and pulsatility indexes(r=0.81;P<0.001),while both resistance and pulsatility indexes had correlated negative with estradiol(r=-0.71 and r=-0.91;P<0.001),and nitric oxide metabolites(r=-0.92 and r=-0.72;P<0.001).Conclusions:Three-year old Baladi bull has the lesser Doppler indices with lesser echotexture and greater nitric oxide with estradiol concentrations,which directs a significant ability for the thermoregulation process.These parameters will help in breeding selection.

血流阻力指数在乳腺肿瘤良恶性鉴别诊断中的价值

目的:通过多普勒超声测得乳腺肿瘤血流阻力指数(RI),分析RI与乳腺肿瘤良恶性之间的关系。方法:选取2022年4-12月在我院行乳腺肿瘤手术并有病理结果的患者100例作为研究对象。100例患者均在术前彩超肿物定位检查中测得RI值,并在测量过程中,采取相应的手法和技巧,力求降低RI测值的人为变动因素,从而分析RI指标与乳腺肿瘤良恶性之间的关系并观察是否有更为准确的RI预测标准。结果:100例有手术病理结果的乳腺肿瘤患者中,恶性51例,良性49例;经ROC曲线统计分析,AUC(ROC曲线下方的面积)为0.87,RI>0.70为诊断标准,以该值为参考诊断乳腺癌的准确性为81%,灵敏度为82.4%、特异度为79.6%。结论:RI测量对乳腺肿瘤良恶性的鉴别诊断有一定的价值。乳腺肿瘤良恶性的鉴别诊断中,典型的肿块超声二维图像已有不少特征性的表现,诊断并不困难,但对于形态学改变并不突出、鉴别有困难的肿块,如恶变早期的病灶,RI值的测量则可以增加诊断筹码,为临床提供更接近真相的结果。

子宫动脉RI、PI、S/D参数预测妊娠合并抗磷脂综合征患者胚胎停育的临床价值

目的:探究子宫动脉阻力指数(RI)、血流搏动指数(PI)、子宫动脉收缩期与舒张期流速比(S/D)参数预测妊娠合并抗磷脂综合征患者胚胎停育的临床价值。方法:回顾性分析南京医科大学附属泰州人民医院2018年12月-2021年12月收治的102例妊娠合并抗磷脂综合征患者,收集并整理患者的基础资料,并采用彩色多普勒超声检查子宫动脉的RI、PI、S/D参数。根据患者发育情况将其分为胚胎停育组和胚胎良好组。采用Logistic多因素回归分析探讨影响妊娠合并抗磷脂综合征患者胚胎停育的相关因素,以受试者工作特征曲线(ROC)评估子宫动脉RI、PI、S/D参数对妊娠合并抗磷脂综合征胚胎停育的预测价值。结果:102例妊娠合并抗磷脂综合征患者中出现胚胎停育10例(9.80%),胚胎良好92例(90.20%)。胚胎停育组与胚胎良好组的年龄、BMI、孕周、吸烟、饮酒、高血压、糖尿病比较,差异无统计学意义(P>0.05),胚胎停育组子宫动脉RI、PI、S/D高于胚胎良好组,差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,子宫动脉RI、PI、S/D均为妊娠合并抗磷脂综合征患者胚胎停育的影响因素(P<0.05);ROC分析结果显示,子宫动脉RI、PI、S/D联合联测妊娠合并抗磷脂综合征胚胎停育的敏感度为78.92%,特异度为97.40%,曲线下面积(AUC)为0.900,高于RI、PI、S/D单一预测效能(P=0.000)。结论:子宫动脉RI、PI、S/D参数可用于预测妊娠合并抗磷脂综合征胚胎停育,且联合预测效能较高,值得推广应用。

乳腺癌患者的超声特征及其影响因素

目的探讨乳腺癌患者的超声特征及其影响因素。方法选取75例乳腺癌患者和125例乳腺良性疾病患者,分别作为观察组和对照组。比较两组患者的超声特征,比较不同临床特征乳腺癌患者的超声特征,采用Logistic回归模型分析乳腺癌患者超声特征的影响因素。结果观察组中肿块形状不规则、后方回声弱、血流分级≥Ⅱ级、阻力指数﹥0.08的患者比例均明显高于对照组,差异均有统计学意义(P﹤0.01)。中低分化、有淋巴结转移、Ⅲ~Ⅳ期乳腺癌患者肿块形状不规则、后方回声弱、血流分级≥Ⅱ级、阻力指数﹥0.08的比例分别高于高分化、无淋巴结转移、Ⅰ~Ⅱ期患者,差异均有统计学意义(P﹤0.05)。多因素回归分析结果显示,分化程度是乳腺癌患者肿块形状不规则、后方回声弱、血流分级≥Ⅱ级以及阻力指数﹥0.08的独立影响因素(P﹤0.05)。结论超声检查对乳腺癌具有一定的诊断作用,且不同临床特征的乳腺癌患者的超声特征不同。

肝脏超声血流参数联合血清微小RNA-1203预测乙型肝炎病毒相关性肝癌患者肝动脉化疗栓塞术疗效的研究

目的 观察肝脏超声血流参数联合血清微小RNA-1203 (microRNA-1203,miR-1203)对乙型肝炎病毒(hepatitis B virus,HBV)相关性肝癌患者肝动脉化疗栓塞术(transcatheter arterial chemoembolization,,TACE)疗效的预测价值。方法 选取河北医科大学附属第三医院2019年8月至2022年8月收治的113例HBV相关性肝癌患者作为研究对象,研究方法为前瞻性研究,于治疗前收集患者基线资料,行肝脏超声检查,记录血流参数,检测患者血清miR-1203水平,实施TACE治疗,评估疗效,根据疗效评估结果,将完全缓解+部分缓解+稳定患者纳入缓解组,将进展患者纳入未缓解组。采用多因素Logistic回归分析检验超声血流参数、血清miR-1203与HBV相关性肝癌患者TACE疗效的关系,并绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线),分析超声血流参数联合血清miR-1203对HBV相关性肝癌患者TACE疗效的预测效能。结果 113例HBV相关性肝癌患者中,有85例缓解,纳入缓解组,有28例未缓解,纳入未缓解组。初步比较未缓解组与缓解组的基线资料、超声血流参数及miR-1203水平后,经多因素Logistic回归分析结果显示,Child-Pugh分级B级,病灶最大直径长,天冬氨酸转氨酶(aspartate transaminase,AST)、丙氨酸转氨酶(alanine transaminase,ALT)、肝脏阻力指数(resistance index,RI)、肝脏搏动指数(pulse index,PI)、miR-1203相对表达量高水平是TACE治疗后未缓解的危险因素(P<0.05);肝脏最大血流速度(peak systolic velocity,PSV)高是TACE治疗后未缓解的保护因素(P<0.05)。绘制ROC曲线结果显示PI、RI、PSV、超声血流参数联合、血清miR-1203单项及四项指标联合预测HBV相关性肝癌患者TACE疗效的曲线下面积分别为0.771、0.764、0.722、0.855、0.753、0.892,均>0.70,均有一定的预测价值。结论 HBV相关性肝癌患者行TACE治疗后未缓解与多种因素有关,其中超声血流参数、血清miR-1203可作为预测疗效的有效手段。

孕妇胎盘内部血流参数与妊高症关系研究

目的探讨孕妇胎盘内部血流参数与妊娠期高血压疾病(PIH,简称妊高症)的相关性。方法选择2018年7月—2019年8月期间在十堰市人民医院进行产前超声检查的120例孕妇,筛选出其中符合课题实验要求的孕妇进行临床研究,根据其病情严重程度,将所有参与本课题实验的孕妇分为观察组与对照组,其中观察组中包含妊娠期高血压(GH)组、重度子痫前期组,采用彩色多普勒超声对其子宫动脉血流与胎盘内部血流灌注情况进行检测,记录其动脉阻力指数与胎盘内部血流参数等。结果在120例孕妇中共诊断出24例GH患者,16例重度子痫前期患者。相较于GH患者与余下80例正常孕妇而言,重度子痫前期患者的各项胎盘血流参数均较低(P<0.05)。当孕妇胎盘内部血流参数降低至一个临界值时,VI值达到26.84,FI值>26.63。结论当孕妇处于孕中期时,各项胎盘内部血流参数均会降低,能够实现对PIH的有效预测。同期检测出的孕妇子宫动脉阻力指数,则无法对孕晚期内PIH的出现进行准确的预测。

彩色多普勒超声肱动脉血流量/肱动脉阻力指数评价动静脉内瘘狭窄的价值

目的 应用彩色多普勒超声探讨肱动脉血流量(blood flow volume,Qa)/阻力指数(resistance index,RI)评价动静脉内瘘狭窄的价值。方法 回顾性分析2020年1月~2021年9月在大连理工大学附属大连市中心医院肾内科透析的患者,根据超声测量静脉内径,<2mm为狭窄组(n=75),≥2mm为正常组(n=109),记录超声测量指标Qa、RI、Qx(肱动脉血流量/阻力指数,Qx=Qa/RI)及性别、年龄、体质量指数(body mass index,BMI)、是否患有糖尿病、是否吸烟等。结果 狭窄组和正常组在性别(t=1.400,P=0.270)、BMI(χ^(2)=9.105,P=0.448)、是否吸烟(t=0.043P,=0.834)的差异没有统计学意义。正常组和狭窄组比较在糖尿病(t=0.059,P<0.001)、Qa(χ^(2)=42.868,P<0.001)、RI(χ^(2)=42.823,P<0.001)、Qx(χ^(2)=40.919,P<0.001)差异有统计学意义。Logistic回归分析结果显示Qx是诊断内瘘狭窄的有效指标(OR=0.997,95%CI:0.995~0.998,P<0.001)。ROC曲线结果显示:Qx与Qa没有显著差异,Qx与RI有显著差异(AUC Qa-Qx,P=0.071,AUC Qx-RI,P<0.001)。结论 Qx是评估内瘘狭窄的有效指标,结合Qa和RI可以有效诊断内瘘狭窄。

术前彩色多普勒超声血流参数对甲状腺乳头状癌术后预后的预测价值

目的 研究术前彩色多普勒超声血流参数对甲状腺乳头状癌(PTC)术后预后的预测价值。方法 选取2019年1月—2021年1月收治的116例PTC,根据预后情况分为预后良好组和预后不良组。所有受试者于手术治疗前行彩色多普勒超声检查,获得病灶部位血流参数。采用多因素Logistic回归分析明确PTC术后患者预后不良的危险因素,绘制受试者工作特征(ROC)曲线评估彩色多普勒超声血流参数对PTC术后预后的预测价值。结果 多因素Logistic回归分析结果显示,甲状腺包膜侵犯、淋巴结转移、甲状腺球蛋白>40μg/L、阻力指数(RI)、搏动指数(PI)、收缩期峰值血流速度(PSV)是影响PTC术后患者预后不良的独立危险因素(P<0.01)。RI、PI、PSV联合预测PTC术后患者预后不良的受试者工作特征曲线下面积、约登指数分别为0.863、61.30%,均高于上述指标单独预测(P<0.01)。结论RI、PI、PSV高水平是影响PTC术后患者预后不良的独立危险因素,预测PTC术后患者预后不良的价值较高,且联合检测的预测价值更高。

彩色多普勒超声评估多囊卵巢综合征患者子宫内膜厚度及卵巢血流动力学的价值

目的 分析彩色多普勒超声评估多囊卵巢综合征患者子宫内膜厚度及卵巢血流动力学的价值。方法 选取60例多囊卵巢综合征患者为研究组,同期60例月经正常女性为对照组。比较研究组与对照组、促排卵成功组与促排卵失败组的子宫内膜厚度与卵巢血流阻力指数。结果 研究组卵巢血流阻力指数小于对照组,子宫内膜厚度大于对照组(P<0.05)。注射人绒毛膜促性腺激素当日与黄体中期,促排卵成功组的卵巢血流阻力指数小于促排卵失败组,子宫内膜厚度大于促排卵失败组(P<0.05)。结论 彩色多普勒超声检查可准确评估多囊卵巢综合征患者的子宫内膜厚度、卵巢血流阻力指数。