经阴道超声评价二甲双胍治疗胰岛素抵抗的多囊卵巢综合征的临床意义

目的探讨经阴道彩色多普勒超声(TV-CDU)在评价二甲双胍治疗胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)疗效中的临床意义。方法利用TV-CDU对35例胰岛素抵抗的多囊卵巢综合征(PCOS-IR)妇女二甲双胍治疗前后卵巢结构[表面积(TA)、基质面积(SA)、卵泡计数]及基质动脉血流动力学参数[收缩期峰速(PSV)、舒张期速度(PDV)、阻力指数(RI)、收缩期峰速与舒张期低速的比(S/D)]进行对比检测,并测定生殖激素促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)及空腹血糖(FBS)和空腹胰岛素(FINS)水平。结果PCOS-IR妇女二甲双胍治疗后LH、LH/FSH、T及IR显著降低。TA、SA、SA/TA及卵泡计数显著减少,RI、S/D显著升高。相关分析显示SA/TA、卵泡计数及卵巢基质动脉RI、S/D的变化与激素的变化相关性良好。结论TV-CDU通过对卵巢形态和血供的分析可有效评价二甲双胍治疗疗效。

Clinical Significance of Transvaginal Ultrasound Evaluating Metformin Therpeutic Effect in Polycystic Ovary Syndrome Patients Accompanied with Insulin Resistance

Objective To investigate the clinical value of transvaginal color Doppler ultrasound (TV-CDU) in polycystic ovarian syndrome (PCOS) accompanied with insulin resistance (IR) treated with metformin. ~Methods The features of ovarian morphology(stromal area,SA,total area,TA),the number of follicles and the blood parameters of ovarian stromal artery(PSV,PDV,RI,S/D)in 35 cases with PCOS-IR were detected with TV-CDU;the levels of LH,FSH,T,fasting blood-glucose (FBS) and fasting serum insulin(FIN) were tested;the SA/TA,LH/FSH and IR were calculated before and after metformin administration.Results The levels of LH,LH/FSH,T and IR were decreased significantly;the number of follicles and SA/TA dropped significantly;the RI,S/D were increased significantly The changes of the number of follicles,parameters of ovarian morphology and blood parameters were analyzed and correlated with the changes of IR.The changes of the number of follicles,SA/TA and RI,S/D had significant correlations with the changes of IR and generative hormones respectively.Conclusions TV-CDU is useful to assess the effect of metformin by combining RI,S/D,SA/TA with the number of follicles.