万娟

【摘要】 目的：探究经阴道彩色多普勒超声（TVUS）检测卵巢早衰（POF）血流变化及与性激素水平的关系。方法：选择2017年10月-2020年8月来本院进行检查的POF患者38例为POF组，另选取同期来本院行健康体检的35例育齡期女性作为对照组。所有参检者均行TVUS检查及性激素水平测定。比较两组超声征象、卵巢血流动力学指标[收缩期峰值流速（PSV）、动脉舒张末期流速（EDV）、搏动指数（PI）、阻力指数（RI）]、性激素水平[卵泡刺激素（FSH）、雌二醇（E2）]，分析卵巢血流动力学与性激素水平的关系。结果：POF组卵泡数少于对照组，卵泡大小、内膜厚度、左右侧卵巢左右径及前后径均短于对照组，差异均有统计学意义（P<0.05）。POF组PSV、EDV水平均低于对照组，PI、RI均高于对照组，差异均有统计学意义（P<0.05）。POF组FSH水平高于对照组，E2水平低于对照组，差异均有统计学意义（P<0.05）。Pearson相关性分析显示，POF患者PSV与FSH呈负相关（r=-0.850，P<0.05），PSV与E2呈正相关（r=0.468，P<0.05）;EDV、PI、RI与性激素水平无明显相关性。结论：POF患者血流动力学变化特点是PSV、EDV水平下降，PI、RI值升高，且与FSH及E2间存在相关性，故可将TVUS作为诊断POF的辅助手段，为临床进一步明确诊断提供参考。

【关键词】 卵巢早衰 经阴道彩色多普勒超声 血流动力学 性激素

The Relationship between Blood Flow Changes and Sex Hormone Level in Premature Ovarian Failure Detected by Transvaginal Color Doppler Ultrasound/WAN Juan. //Medical Innovation of China， 2021， 18（28）： -161

[Abstract] Objective： To explore the relationship between blood flow changes and sex hormone level in premature ovarian failure （POF） detected by transvaginal color Doppler ultrasound （TVUS）. Method： A total of 38 cases of POF patients examined in our hospital from October 2017 to August 2020 were selected as the POF group， and 35 cases of women of childbearing age who underwent physical examination in our hospital during the same period were selected as the control group. All participants underwent TVUS examination and sex hormone level determination. The ultrasonic signs， ovarian hemodynamics index [peak systolic velocity （PSV）， arterial end-diastolic velocity （EDV）， pulse index （PI）， resistance index （RI）]， sex hormone level [follicle-stimulating hormone （FSH）， estradiol （E2）] were compared between two groups， the relations between ovarian hemodynamics and sex hormone level were analyzed. Result： The number of follicles in the POF group was less than that in the control group， and the follicle size， endometrial thickness， left and right ovarian diameter， and anteroposterior ovarian diameter in the POF group were shorter than those in the control group， the differences were statistically significant （P<0.05）. The levels of PSV and EDV in the POF group were lower than those in the control group， while PI and RI in the POF group were higher than those in the control group， the differences were statistically significant （P<0.05）. The level of FSH in the POF group was higher than that in the control group， and the level of E2 in the POF group was lower than that in the control group， the differences were statistically significant （P<0.05）. Pearson correlation analysis showed that PSV was negatively correlated with FSH （r=-0.850， P<0.05）， and PSV was positively correlated with E2 （r=0.468， P<0.05）. EDV， PI， RI had no significant correlation with sex hormone level. Conclusion： The hemodynamics changes of POF patients are characterized by the decrease of PSV and EDV， and the increase of PI and RI values， which are correlated with FSH and E2. Therefore， TVUS can be used as an auxiliary means for the diagnosis of POF， and provide reference for further clinical diagnosis.

[Key words] Premature ovarian failure Transvaginal color Doppler ultrasound Hemodynamic Sex hormone

First-author’s address： Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2021.28.039

卵巢早衰（POF）指卵巢功能出现减退的现象，临床对于POF发病机制暂无明确定义。目前公认的诊断标准为年龄<40岁，闭经时间≥6个月，超过两次检查血清卵泡刺激素（FSH）>40 U/L，血清雌二醇（E2）水平<73.2 pmol/L，患者可出现不孕、闭经、雌激素缺乏等症状，已对患者生活质量造成影响[1-2]。早诊断、早干预对改善POF患者病情具有重要作用。随着超声技术的不断完善及发展，经阴道彩色多普勒超声（TVUS）在POF中的得到应用，能够更好地觀察卵巢体积、是否存在卵泡及血流动力学参数变化等情况，为临床诊断及治疗干预提供可靠依据[3-4]。……