邹淑伟 韩彦峰 吴秀英

[摘要] 目的 探討彩色多普勒超声检查技术及微血管密度（MVD）在评价反复自然流产患者子宫内膜容受性中的应用价值。 方法 选取2016年12月～2017年12月温岭市妇幼保健院门诊收治的61例反复自然流产患者作为研究对象，根据是否妊娠分为妊娠组（n=25）与非妊娠组（n=36）所有患者均接受彩色多普勒超声检查以及内膜活检，比较两组内膜血流分布、血流动力学参数以及内膜微血管密度（MVD）情况。 结果 两组患者年龄、流产次数、体重指数、卵泡刺激素、黄体生成素水平比较差异无统计学意义（t=0.382、0.257、0.644、0.152、0.243，均P > 0.05）；并且两组患者子宫内膜厚度、内膜容积、子宫动脉PI、RI、S/D指标比较差异无统计学意义（t=0.416、0.117、0.416、1.046、0.240，均P > 0.05），但非妊娠组患者子宫螺旋动脉血流参数PI、RI、S/D水平明显高于妊娠组，差异有统计学意义（t=2.927、3.062、4.195，均P < 0.05）；非妊娠组患者平均MVD水平明显低于妊娠组，差异有统计学意义（t=8.515，P < 0.05）。 结论 经阴道彩色多普勒超声检查技术在评价反复自然流产患者子宫内膜容受性中具有一定的临床价值，通过对螺旋动脉血流参数的检测能够初步预测患者的妊娠结局，结合内膜病理检查可为反复自然流产患者的临床治疗提供指导。

[关键词] 彩色多普勒超声；反复自然流产；子宫内膜容受性；微血管密度；应用价值

[中图分类号] R714.8 [文献标识码] A [文章编号] 1673-7210（2018）05（b）-0054-04

Study on the application value of color Doppler ultrasound and MVD in the evaluation diagnostic of recurrent spontaneous abortion in patients with endometrial receptivit

ZOU Shuwei1 HAN Yanfeng2 WU Xiuying1

1.Department of Ultrasound， Maternal and Child Health Hospital of Wenling， Zhejiang Province， Wenling 317500， China； 2.Department of Ultrasound， Hospital of Integrated Chinese and Western Medicine， Zhejiang Province， Taizhou 318000， China

[Abstract] Objective To discuss on the application value of color Doppler ultrasound and MVD in the evaluation diagnostic of recurrent spontaneous abortion in patients with endometrial receptivit. Methods From December 2016 to December 2017， 61 cases of recurrent spontaneous abortion as the object in Maternal and Child Health Hospital of Wenling were selected and divided into pregnancy group （n = 25） and non-pregnancy group （n = 36） according to whether had pregnancy. All the patients underwent color doppler ultrasound examination and endometrial biopsy， endometrial blood flow distribution， hemodynamic parameters and endometrial microvessel density （MVD） between the two groups were compared. Results There were no significant differences in age， abortion frequency， BMI and estrogen levels between the two groups （t = 0.382， 0.257， 0.644， 0.152， 0.243， all P > 0.05）. There were no significant difference in the endometrial thickness， endometrial volume， uterine artery PI， RI and S/D indexes （t = 0.416， 0.117， 0.416， 1.046， 0.240， all P > 0.05）， but the levels of PI， RI and S/D in uterine spiral blood were significantly higher than the non-pregnant group （t = 2.927， 3.062， 4.195， all P < 0.05）. There was statistically significant in the average MVD between two groups （t = 8.515， P < 0.05）. Conclusion There is a certain clinical value in evaluating endometrial receptivity in patients with recurrent spontaneous abortion by transvaginal color doppler ultrasonography， they can predict the patients′ pregnancy outcome through the detection of helical artery blood flow parameters， can provide guidance for clinical treatment for patients with recurrent spontaneous abortion by endometrial examination.

[Key words] Color Doppler ultrasound； Recurrent spon？鄄taneous abortion； Endometrial receptivity； Microvessel density； Application value

自然流产在临床上较为常见，并且以早期自然流产发生率最高，相关调查研究显示具有早期自然流产史的患者再次发生早期自然流产的风险明显高于正常健康育龄期女性，尤其是与同一伴侣发生过2次以上流产的反复自然流产患者[1]。近年来针对反复自然流产的研究发现[2]，子宫内膜容受性不足患者存在胚泡着床率明显降低、自然流产率增加的风险，而内膜容受性代表着子宫内膜在某一特定时期内接受胚泡的能力，因此子宫内容容受性直接影响患者的妊娠结局。相关……