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.

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。

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.

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。

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。

温经止痛汤联合推拿对原发性痛经患者的治疗价值

目的:探讨温经止痛汤联合推拿对原发性痛经患者的治疗价值。方法:选取2020年1月至2023年3月北京中医药大学东方医院收治的原发性痛经患者150例作为研究对象,采用随机数表法分为观察组和对照组,每组75例。对照组给予推拿治疗,观察组在对照组基础上联合温经止痛汤。比较2组临床疗效,同时评估其中医证候积分以及视觉模拟评分法(VAS),另外测定2组列腺素F_(2α)(PGF_(2α))、前列腺素E_(2)(PGE_(2))、β-内啡肽(β-EP)、P物质(SP)、多巴胺(DA)、5-羟色胺(5-HT)水平、子宫动脉血流搏动指数(PI)、血流阻力指数(RI)、收缩期峰值/舒张期峰值(S/D)。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后各中医证候评分评分低于对照组,差异有统计学意义(P<0.05);观察组治疗后VAS评分(1.21±0.15)分低于对照组(2.03±0.56)分,差异有统计学意义(t=12.249,P=0.000);观察组治疗后血清PGF_(2α)、SP、DA、5-HT水平低于对照组,血清PGE_(2)、β-EP水平高于对照组,观察组治疗后PI、RI、S/D指标低于对照组,差异有统计学意义(P<0.05)。结论:温经止痛汤联合推拿治疗原发性痛经不仅能有效改善患者临床症状、体征以及疼痛,还能改善其血清PGF_(2α)、疼痛相关因子水平以及子宫动脉血流动力学指标。

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。

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。

颈部血管超声评估椎动脉颅内段狭窄的可行性分析

目的探讨颈部血管超声的血流动力学参数评估椎动脉颅内段狭窄的可行性。方法回顾性连续纳入2014年1月至2015年1月苏州大学附属第一医院神经内科以头痛、头晕为主诉的患者150例,根据单侧椎动脉颅内段是否有狭窄分为研究组[100例;一侧椎动脉管径(VAD)≤2.5 mm或与对侧VAD比值<1/1.7,且椎动脉颅内段狭窄]和单纯椎动脉发育不全(VAH)组(50例;一侧VAD≤2.5 mm或与对侧VAD比值<1/1.7,椎动脉全程未见狭窄),并纳入同期健康体检人群100例作为对照组(双侧VAD>2.5 mm,椎动脉全程无狭窄)。所有研究对象行颈部血管超声、CT血管成像(CTA)和(或)DSA检查。采用颈部血管超声记录VAD、收缩期峰值流速(PSV)、舒张期末流速(EDV)、阻力指数、时均平均峰值流速,并计算椎动脉血流量及阻力指数差值。比较3组血流动力学参数的差异,并对研究组患侧、单纯VAH组VAH侧、对照组左侧进行两两比较;评价不同参数对椎动脉颅内段狭窄诊断的可行性。结果椎动脉椎间段阻力指数诊断准确性较高,阻力指数差值、血流量、EDV、VAD有一定准确性,PSV的诊断准确性较差;其中,阻力指数为0.754、阻力指数差值为0.151、血流量为56.52 ml/min、EVD为9.5 cm/s、VAD为2.095 mm是诊断椎动脉颅内段狭窄最佳界值(最大Youden指数分别为0.695、0.605、0.383、0.495、0.381,敏感度分别为83.8%、63.6%、89.8%、81.6%、87.6%,特异度分别为85.7%、96.9%、48.5%、67.9%、50.5%,准确度分别为87.3%、80.2%、79.5%、67.7%、65.2%)。结论颈部血管超声检测椎动脉椎间段阻力指数、阻力指数差值、血流量、EDV、VAD可作为评估椎动脉颅内段狭窄的参考,为及早诊断后循环缺血提供依据。

红景天胶囊对犬心肌耗氧量及冠脉血流量的影响

结果表明，红景天胶囊可显著降低麻醉犬心肌耗氧量和耗氧指数，大剂量且能降低冠脉阻力，对冠脉血流量则无明显影响。本品还有一定的降低血压和减慢心率的作用。

妊娠高血压综合征血液流变学与胎儿脑血流阻力指标相关性分析

目的 :产前预测胎儿窘迫 ,及时发现异常 ,及时处理 ,降低围产儿病残率和死亡率。方法 :测定妊高征孕妇全血及血浆粘度 ,包括全血比粘度高切 (BVH)、全血比粘度低切 (BVL)、全血还原比粘度、血浆粘度 (PV)、红细胞压积(HCT)、纤维蛋白原 (Fib) ;运用彩色多普勒测胎儿大脑中动脉 (MCA)血流阻力指标 (S/ D、PI、RI值的统称 )。结果 :妊高征孕妇血液流变学检测比较 ,重度妊高征大于中度妊高征、中度妊高征大于轻度妊高征。妊高征孕妇血液流变学各值与胎儿 MCA血流阻力指标各值呈负相关性。当孕妇血液流变学各值增高 :BVH≥ 4 .6 3、BVL≥ 6 .2 3、PV≥ 1.6 8、HCT≥0 .36时可预测妊高征的发生 ,及对围产儿有不良影响 ;当胎儿 MCA血流 S/ D≤ 4、PI≤ 1.6、RI≤ 0 .6时 ,预测胎儿窘迫的发生 ,以上各值可作为临界值 ,及时发现异常 ,及时处理。结论 :监测孕妇血液流变学及胎儿 MCA血流阻力指标各值 ,可提高预测胎儿窘迫的准确性 ,及时发现异常 ,及时处理 ,保障母婴健康 。

肱动脉多普勒超声对血液透析自体动静脉内瘘的诊断价值

目的应用超声检测肱动脉多普勒参数评估自体动静脉内瘘的功能。方法将102例患者按血液透析期间泵血流量正常、泵血流量减少分为功能正常组66例、功能障碍组36例,应用多普勒超声测量肱动脉的血流量、阻力指数(RI)及搏动指数(PI),比较两组肱动脉相关参数的差异;绘制受试者工作特征(ROC)曲线,分析肱动脉相关参数预测自体动静脉内瘘结局的诊断效能。结果功能正常组与功能障碍组肱动脉血流量、RI、PI比较差异均有统计学意义(均P<0.05);肱动脉血流量、RI、PI预测结局的截断值分别为455 ml/min、0.53、0.82,ROC曲线下面积分别为0.747、0.807、0.977,敏感性分别为55.56%、55.56%、86.11%,特异性分别为90.91%、93.94%、100%。结论肱动脉血流量、RI、PI等多普勒参数可为血液透析患者自体动静脉内瘘功能提供有价值的信息,其中肱动脉PI预测价值更高。

金凤丸联合生物电刺激治疗薄型子宫内膜临床观察

目的:观察探讨金凤丸联合生物电刺激治疗薄型子宫内膜的临床疗效。方法:选取我院生殖门诊就诊的82例不明原因所致薄型子宫内膜患者,随机分成两组,对照组41例,口服金凤丸同时给予补佳乐2 mg/d口服;治疗组41例,在应用金凤丸和补佳乐的基础上,于月经周期第8天开始给予生物电刺激治疗,隔日1次,至排卵日,进行治疗3个周期,比较两组患者治疗前后子宫内膜厚度、子宫内膜血流变化(RI、PI、S/D)、妊娠率、流产率。结果:治疗组较对照组在排卵日子宫内膜增厚明显,两组具有显著性差异,P<0.05,两组子宫内膜血流变化也有显著性差异,P<0.05,并且在妊娠率比较上,治疗组明显高于对照组,流产率方面治疗组低于对照组。结论:金凤丸联合生物电刺激对于治疗薄型子宫内膜患者具有明显疗效,值得临床推广应用。

彩色多普勒能量图对不孕症妇女子宫动脉血流变化的观察

利用彩色多普勒能量图测定子宫的血流 ,即血流的脉冲指数 (pulsative index,PI)及阻力指数 (resistantindex,RI)来探索不同原因的女性不孕症。 6 7例不孕症妇女经腹腔镜诊断确诊不孕原因后 ,于月经周期第 2 0～ 2 3d作腹部 B超彩色多普勒能量图 (CDE)检查。其结果两侧子宫动脉 PI、RI可因各种不孕原因不分侧别平均 PI、RI均高于正常组 (P<0 .0 1) ,而且不受病情轻、中、重所影响。反映了子宫周围血管阻力较高所致子宫动脉血流灌注不足是引起不孕症的基础 ,可能也干扰孕卵着床而致不孕。