中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2011年
5期
350-354
,共5页
贺丽荣%周力学%潘锐柯%张莘
賀麗榮%週力學%潘銳柯%張莘
하려영%주역학%반예가%장신
多囊卵巢综合征%成像,三维%超声检查%卵泡
多囊卵巢綜閤徵%成像,三維%超聲檢查%卵泡
다낭란소종합정%성상,삼유%초성검사%란포
Polycystic ovary syndrome%Imaging,three-dimensional%Ultrasonography%Ovarian follicle
目的 探讨经阴道或直肠三维超声自动体积测量(SonoAVC)技术在多囊卵巢综合征(PCOS)诊断中的价值.方法 使用SonoAVC技术分级计数80例PCOS患者(PCOS组)卵巢内的卵泡数,并测量卵巢体积,以60例输卵管或男性因素的不孕症患者为对照组;测定观察对象早卵泡期的血生殖激素水平,并分析PCOS患者卵泡数、卵巢体积和血生殖激素水平之间的关系.结果 PCOS 组患者的卵巢体积[(11 ±8)ml]、总卵泡数[(27±14)个]及直径≥2～＜6 mm卵泡数[(22±19)个]显著高于对照组[分别为(6 ±4)ml、(6 ±4)个及(2±3)个],分别比较,差异均有统计学意义(P＜0.05);直径≥6～≤9 mm卵泡数与对照组类似,两组比较,差异无统计学意义(P＞0.05).总卵泡数及直径≥2～＜6 mm卵泡数与卵巢体积呈正相关(相关系数分别为0.600、0.618,P＜0.01),直径≥2～＜6 mm卵泡数与总卵泡数也呈正相关(相关系数为0.916,P＜0.01);直径≥6～≤9 mm卵泡数与卵巢体积及总卵泡数呈负相关(相关系数分别为-0.618、-0.263,P均=0.001);总卵泡数及直径≥2～＜6 mm卵泡数与血睾酮水平呈正相关(相关系数分别为0.364、0.291,P=0.001、P＜0.05);卵巢体积与卵泡刺激素(FSH)水平呈负相关(相关系数为-0.226,P=0.042),与黄体生成素(LH)/FSH比值呈正相关(相关系数为0.282,P=0.010).结论 PCOS患者的卵巢体积、总卵泡数、直径≥2～＜6 mm卵泡数显著高于对照人群.卵巢体积越大,总卵泡数及直径≥2～＜6 mm卵泡数增多的可能性越大;血睾酮水平越高,总卵泡数增多的可能性越大,主要以直径≥2～＜6 mm小卵泡绝对增加为主.这些超声特征在一定程度上反映了PCOS患者卵巢的病理生理变化及相应的临床生化改变.SonoAVC卵泡计数法为PCOS患者提供了一种新的客观的卵泡计数方法,使用SonoAVC技术分级计数卵泡数对PCOS的诊断具有重要的临床意义.
目的 探討經陰道或直腸三維超聲自動體積測量(SonoAVC)技術在多囊卵巢綜閤徵(PCOS)診斷中的價值.方法 使用SonoAVC技術分級計數80例PCOS患者(PCOS組)卵巢內的卵泡數,併測量卵巢體積,以60例輸卵管或男性因素的不孕癥患者為對照組;測定觀察對象早卵泡期的血生殖激素水平,併分析PCOS患者卵泡數、卵巢體積和血生殖激素水平之間的關繫.結果 PCOS 組患者的卵巢體積[(11 ±8)ml]、總卵泡數[(27±14)箇]及直徑≥2～＜6 mm卵泡數[(22±19)箇]顯著高于對照組[分彆為(6 ±4)ml、(6 ±4)箇及(2±3)箇],分彆比較,差異均有統計學意義(P＜0.05);直徑≥6～≤9 mm卵泡數與對照組類似,兩組比較,差異無統計學意義(P＞0.05).總卵泡數及直徑≥2～＜6 mm卵泡數與卵巢體積呈正相關(相關繫數分彆為0.600、0.618,P＜0.01),直徑≥2～＜6 mm卵泡數與總卵泡數也呈正相關(相關繫數為0.916,P＜0.01);直徑≥6～≤9 mm卵泡數與卵巢體積及總卵泡數呈負相關(相關繫數分彆為-0.618、-0.263,P均=0.001);總卵泡數及直徑≥2～＜6 mm卵泡數與血睪酮水平呈正相關(相關繫數分彆為0.364、0.291,P=0.001、P＜0.05);卵巢體積與卵泡刺激素(FSH)水平呈負相關(相關繫數為-0.226,P=0.042),與黃體生成素(LH)/FSH比值呈正相關(相關繫數為0.282,P=0.010).結論 PCOS患者的卵巢體積、總卵泡數、直徑≥2～＜6 mm卵泡數顯著高于對照人群.卵巢體積越大,總卵泡數及直徑≥2～＜6 mm卵泡數增多的可能性越大;血睪酮水平越高,總卵泡數增多的可能性越大,主要以直徑≥2～＜6 mm小卵泡絕對增加為主.這些超聲特徵在一定程度上反映瞭PCOS患者卵巢的病理生理變化及相應的臨床生化改變.SonoAVC卵泡計數法為PCOS患者提供瞭一種新的客觀的卵泡計數方法,使用SonoAVC技術分級計數卵泡數對PCOS的診斷具有重要的臨床意義.
목적 탐토경음도혹직장삼유초성자동체적측량(SonoAVC)기술재다낭란소종합정(PCOS)진단중적개치.방법 사용SonoAVC기술분급계수80례PCOS환자(PCOS조)란소내적란포수,병측량란소체적,이60례수란관혹남성인소적불잉증환자위대조조;측정관찰대상조란포기적혈생식격소수평,병분석PCOS환자란포수、란소체적화혈생식격소수평지간적관계.결과 PCOS 조환자적란소체적[(11 ±8)ml]、총란포수[(27±14)개]급직경≥2～＜6 mm란포수[(22±19)개]현저고우대조조[분별위(6 ±4)ml、(6 ±4)개급(2±3)개],분별비교,차이균유통계학의의(P＜0.05);직경≥6～≤9 mm란포수여대조조유사,량조비교,차이무통계학의의(P＞0.05).총란포수급직경≥2～＜6 mm란포수여란소체적정정상관(상관계수분별위0.600、0.618,P＜0.01),직경≥2～＜6 mm란포수여총란포수야정정상관(상관계수위0.916,P＜0.01);직경≥6～≤9 mm란포수여란소체적급총란포수정부상관(상관계수분별위-0.618、-0.263,P균=0.001);총란포수급직경≥2～＜6 mm란포수여혈고동수평정정상관(상관계수분별위0.364、0.291,P=0.001、P＜0.05);란소체적여란포자격소(FSH)수평정부상관(상관계수위-0.226,P=0.042),여황체생성소(LH)/FSH비치정정상관(상관계수위0.282,P=0.010).결론 PCOS환자적란소체적、총란포수、직경≥2～＜6 mm란포수현저고우대조인군.란소체적월대,총란포수급직경≥2～＜6 mm란포수증다적가능성월대;혈고동수평월고,총란포수증다적가능성월대,주요이직경≥2～＜6 mm소란포절대증가위주.저사초성특정재일정정도상반영료PCOS환자란소적병리생리변화급상응적림상생화개변.SonoAVC란포계수법위PCOS환자제공료일충신적객관적란포계수방법,사용SonoAVC기술분급계수란포수대PCOS적진단구유중요적림상의의.
Objective To investigate clinical significance of counting follicles classification by three-dimensional imaging with sonography based automated volume calculation(SonoAVC)in the diagnosis of polycystic ovary syndrome(PCOS).Methods Eighty cases with PCOS were counted classified follicles and determined ovarian volume by three-dimensional(3D)imaging with SonoAVC method matched with 60 infertile women with fallopian tube or male factors as control.Main clinical.biological and other ultrasonographic markers were assessed during the early follicular phase,and the relationship between the follicle number range per ovary or the volume per ovary and the major hormonal features of PCOS was studied.Results Three-dimensional ultrasound imaging with SonoAVC methed provides a new path for objective quantitative assessment of follicle count.ovarian volume,total follicle numbers.The volume of (11 ±8)ml,total numbers of 27 ±14 follicle and number of22 ±19 follicle with diameter of≥2-＜6 mm in PCOS patients were significantly higher than(6 ±4)ml in ovarian volume.6 ±4 in total follicles and 2 ±3 in follicle with diameter of≥2-＜6 mm in controls(P＜0.05).while follicles were similar for the≥6-≤9mm range(P＞0.05).Total follicle numbers and follicles≥2-＜6 mm had significantly positive relationships with ovarian volume ( r= 0. 600, 0. 618, P＜0. 01 ) and level of testosterones ( r= 0. 364,0. 291, P＜0.05), follicles ≥2-＜6 mm also had significantly positive relationships with total follicle number (r=0. 916,P＜0. 01 ). The follicles within the ≥6 - ≤9 mm range was significantly and negatively related to ovarian volume and total follicle numbers ( r = - 0. 618, - 0. 263, all P = 0. 001 ), but no significantly related to the major hormonal features of PCOS. The ovarian volume was significantly positively related with luteinizing hormone ( LH)/follicle stimulating hormone (FSH) ratio ( r= 0. 282, P = 0. 010)but negatively related to FSH level (r = - 0. 226, P = 0. 042). Conclusions Ovarian volume, total follicle numbers and follicles ≥2 - ＜6 mm in PCOS patients were significantly higher than those in controls. The larger ovarian volume might produce more total follicle and follicles ≥ 2 - ＜6 mm. The higher level of testosterone might produce more total follicle probably, which mainly result in more follicles ≥2 -＜6 mm.These morphologically ultrasonographic characteristics could reflect pathophysiological changes in PCOS. Obviously, it has important clinical significance to count follicles in patients with PCOS by the threedimensional ultrasound imaging with SonoAVC method.
