多囊卵巢综合征的子宫内膜厚度及卵巢血液改变的超声诊断

目的探讨超声诊断在多囊卵巢综合征的子宫内膜厚度及卵巢血液改变中的应用价值。方法选取我院2012年12月~2013年6月接收的多囊卵巢综合征患者47例(观察组),患者均行超声检查,另选同期接受超声诊断的32例因男性因素不孕来院就诊且身体健康无异常者为对照组,观察两组子宫内膜厚度及卵巢血液改变参数变化。结果两组经诊断后结果显示,观察组的子宫内膜厚度与收缩期峰值血流速度均明显大于对照组;不同停经天数多囊卵巢综合征患者的子宫内膜厚度与收缩期峰值血流速度比较差异显著,以天数P>90d者值最高;观察组卵巢阻力指数明显低于对照组(上述P<0.05)。结论多囊卵巢综合征患者经超声诊断后结果显示,子宫内膜厚度明显增加,卵巢血流丰富,阻力降低,且因停经天数的不同而变化,具有较高的临床应用价值。     

胰岛素、胰岛素样生长因子Ⅰ及其受体在PCOS患者子宫内膜的表达

目的探讨胰岛素及其受体、胰岛素样生长因子I及其受体在多囊卵巢综合征患者子宫内膜的表达特点。方法利用免疫组化实验技术分析INS、INS-R、IGF-I和IGF-IR在多囊卵巢综合征和非多囊卵巢综合征不孕症患者子宫内膜中的表达情况,对结果进行图像分析,并利用SPSS10.0软件进行统计学分析,比较各组间的差异。结果1.多囊卵巢综合征患者子宫内膜IGF-I和INS-R表达水平明显高于对照组,差异有显著性(P<0.01)。其中多囊卵巢综合征中子宫内膜增生症患者的IGF-I和INS-R表达水平高于多囊卵巢综合征组增殖期患者,差异有显著性(P<0.05)。2.IGF-IR和INS在多囊卵巢综合征患者与对照组子宫内膜的表达水平无明显差异(P>0.05)。结论多囊卵巢综合征患者子宫内膜异常增生可能与局部IGF-I和INS-R表达异常有关。     

颈动脉彩色多普勒超声对老年高血压患者颈动脉病变情况诊断价值

目的探讨颈动脉彩色多普勒超声对老年高血压患者颈动脉病变情况诊断价值。方法抽取60例老年高血压患者与57例健康者分别设为病例组与对照组,均行颈动脉彩色多普勒超声,比较两组检查结果。结果病例组颈动脉狭窄率为88.3%,斑块形成率为80.00%,内膜中层厚度(IMT)、颈动脉内径(D)、阻力指数(RI)均较对照组高(P <0.05);病例组颈内动脉、颈总动脉最大剪切率(SR)以及收缩期峰值流速(PSV)均低于对照组(P <0.05)。结论颈动脉彩色多普勒超声对老年高血压患者颈动脉病变具有较高诊断价值,值得推广。     

经阴道三维容积超声诊断多囊卵巢综合征的临床研究

目的:分析经阴道三维容积超声诊断多囊卵巢综合征(PCOS)的应用价值.方法:选取2019年2月至2020年2月本院收治的40例PCOS患者作为观察组,选取同期于本院接受体检的40例健康女性作为对照组.两组受检者均行阴道超声诊断,分析比较两组的卵泡数量、间质面积、卵巢体积及收缩期最大血流速度(PSV)、动脉阻力指数(RI)、搏动指数(PI).分析卵巢体积参数、卵巢血流参数对PCOS的诊断价值.结果:观察组卵巢体积、间质面积均显著大于对照组;卵泡数量显著多于对照组(P<0.05).观察组的PSV显著大于对照组,RI、PI显著低于对照组(P<0.05).绘制受试者工作特征曲线图(ROC)曲线结果显示,卵巢体积、卵泡数量、间质面积诊断PCOS的曲线下面积(AUC)分别为0.816、0.840、0.843,诊断价值较高;PSV、RI、PI诊断PCOS的AUC分别为0.843、0.824、0.829,诊断价值较高.结论:经阴道三维容积超声诊断对PCOS具有一定诊断价值,测量卵巢体积参数、卵巢血流参数可评估PCOS发生风险.     

阴道彩色多普勒超声对多囊卵巢综合征患者的临床分析

目的：探讨阴道彩色多普勒超声对多囊卵巢综合症(PCOS)患者的临床应用情况。方法将2013年1月~2014年1月在我院接受检查的41例已婚患多囊卵巢综合征的患者分为观察组，并将同期检查的41例月经周期正常的已婚妇女分为对照组，对比两组患者的卵巢形态大小及卵巢动脉血流动力学参数。结果两组的卵巢体积、卵泡数以及卵巢髓质动脉血流RI相比差异均有显著性(<0.05)。结论阴道彩色多普勒超声技术为PCOS的诊断和鉴别诊断奠定了一定的诊断基础，保证PCOS有较高的诊断准确率。     

阴道超声检查多囊卵巢综合征所致不孕症的诊断价值分析

目的分析阴道超声在多囊卵巢综合征所致不孕症中的诊断价值。方法选取多囊卵巢综合征合并不孕症患者80例为观察组,健康育龄妇女80例为对照组,均接受阴道超声检查,比较两组超声检查结果及血流动力学参数等观察指标的差异。结果观察组患者的卵巢体积(12. 13±1. 35) cm~3大于对照组(6. 78±0. 94) cm~3,卵泡数目(14. 98±4. 27)个多于对照组(8. 71±2. 64)个,卵巢髓质面积(S)/卵巢面积(A)(0. 55±0. 06)高于对照组(0. 24±0. 05),差异均有统计学意义(P0. 05);观察组患者收缩期最大流速(PSV为12. 73±2. 64) cm/s较对照组(PSV为8. 93±1. 32) cm/s高,阻力指数(RI为0. 56±0. 07)、搏动指数(PI为0. 95±0. 27)均较对照组(RI为0. 73±0. 09、PI为1. 76±0. 85)低,差异均有统计学意义(P 0. 05)。结论阴道超声是诊断多囊卵巢综合征所致不孕症的重要辅助检查手段,可检测出该病不同于正常育龄妇女卵巢的特征。     

多囊卵巢与左室舒张功能的超声探讨

目的研究多普勒超声对多囊卵巢综合征左心室舒张功能的评估价值。方法选择28例多囊卵巢综合征(PCOS)患者为研究组,28例健康女性为对照组。对两组研究对象进行多普勒超声检查,观察两组研究对象卵巢情况和左心室舒张功能。结果研究组卵泡数目、卵巢体积以及血流指数均高于对照组,P 0. 05。研究组IVSD、LVPWD以及A水平高于对照组,E、E/A低于对照组,均P 0. 05。结论多普勒超声对多囊卵巢综合征患者左心室舒张功能的评估具有重要诊断价值,值得临床应用及推广。     

经阴道超声检查与激素检测在多囊卵巢综合征诊断中的价值分析

目的分析超声检查与激素检测在多囊卵巢综合征诊断中的应用价值。方法随机选取多囊卵巢综合征48例为观察组,同期体检健康女性48例为对照组。对两组受试者均行超声检查和激素检测,并对比两组的血流动力学和血清卵泡雌激素的各项指标。结果观察组的卵巢动脉Vmax明显高于对照组,PI和RI则均显著低于对照组,组间各指标差异均具有统计学意义(P0.05);观察组的超声检查和激素检测各项指标均存在明显变化,且各指标的组间差异均存在统计学意义(P0.05)。结论超声检查与激素检测在多囊卵巢综合征的临床诊断中具有良好的应用价值,可为疾病的早期诊断和鉴别提供参考,适合进行临床推广。     

反复体外受精-胚胎移植失败者母体因素探讨

目的 探讨反复体外受精-胚胎移植失败(RIF)患者可能的母体因素发病机制.方法 对比70例RIF患者和35例孕前体检者,月经第3天血清卵泡刺激素(FSH)、黄体生成素(LH)、子宫体积、卵巢体积、窦卵泡计数(AFC)和排卵期子宫内膜厚度、分型、优势卵泡数量、子宫螺旋动脉的平均搏动指数(PI)和阻力指数(RI).结果 RIF组月经第3天FSH、LH和FSH/ LH数值均明显上升,子宫体积、卵巢体积和AFC数量均显著下降,差异具有统计学意义(P＜0.01);排卵期子宫内膜厚度和优势卵泡数量显著下降,子宫内膜分型A型显著减少,B型和C型明显增加,子宫螺旋动脉PI和RI均明显上升,差异具有统计学意义(P＜0.01).结论 卵巢反应性降低和子宫内膜容受性下降与RIF发生有相关性.     

多囊卵巢综合征患者多普勒超声测量参数与性激素、炎性因子水平的相关性分析

目的 探究多囊卵巢综合征（PCOS）患者多普勒超声测量参数与其性激素、炎性因子水平的相关性。方法 选择PCOS患者120例（病例组），年龄23～35岁，平均年龄30.69岁。另取同期在医院体检健康女性100例（对照组），年龄22～35岁，平均年龄30.25岁。给予两组多普勒超声检查，测量两组子宫、卵巢血流参数[阻力指数（RI）、搏动指数（PI）]，并取肘静脉血检测其性激素[雌二醇（E2）、促卵泡激素（FSH）、促黄体生成素（LH）、睾酮（T）]及炎性因子[肿瘤坏死因子（TNF）-α、白细胞介素6(IL-6)、内皮抑素（ES）]水平，分析PCOS患者多普勒超声血流参数与其血清炎性因子、性激素水平的相关性。结果 两组超声参数比较，病例组子宫RI、PI显著高于对照组（0.89±0.14 vs 0.81±0.12、2.87±0.26 vs2.14±0.21。P <0.05），卵巢RI、PI显著低于对照组（0.43±0.07 vs 0.62±0.12、0.73±0.11 vs 0.91±0.14。P <0.05）。病例组血清LH、T水平显著高于对照组[（9.33±1.64） U/L ...     

子宫内膜息肉发病相关危险因素临床分析

目的 分析子宫内膜息肉（EP）发病的相关危险因素。方法 选取 2016年1月1日~2018 年1月1日在我院妇科就诊行宫腔镜检查及病理组织学确诊为子宫内膜息肉患者456例为观察组,病理提示子宫内膜未见明显异常的102例作为对照组,记录两组患者的年龄、体质指数（BMI）、腰围（WC）、异常出血情况、子宫内膜厚度、是否绝经,有无高血压、糖尿病、子宫肌瘤、子宫腺肌症、宫颈息肉、多囊卵巢综合征,用SPSS统计软件进行单因素及多因素Logistic回归分析。结果 子宫内膜息肉发病年龄集中在30~49岁,占56.36%,主要临床症状是异常子宫出血,占60.96%,经单因素分析结果发现,与EP发病有关的影响因素包括糖尿病、肥胖、胰岛素抵抗、多囊卵巢综合征、子宫腺肌症及宫颈息肉（P＜0.05）,而高血压、高脂血症、子宫肌瘤无明显关系（P＞0.05）。Logistic回归分析显示绝经、胰岛素抵抗及子宫腺肌症是EP发生的危险因素。结论 绝经、子宫腺肌症及胰岛素抵抗是EP发病的危险因素,而对于有异常子宫出血、子宫颈息肉、肥胖、糖尿病、多囊卵巢综合征患者也存在EP高发的可能,在临床中应加强对此类人群的筛查。     

眼外伤的眼底血流动力学研究

目的研究眼外伤的眼底血流动力学变化。方法应用彩色多普勒显像检测６２只正常眼和 ９２只眼外伤患者的视网膜中央动脉（ＣＲＡ）、睫状后短动脉（ＳＰＣＡ）的血流参数,测定收缩期流速（ＰＳＶ）、舒张期流速（ＥＤＶ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）。结果眼外伤组的 ＣＲＡ的 ＰＳＶ、ＲＩ均低于正常组（Ｐ＜０．０１）、ＣＲＡ的 ＥＤＶ、ＰＩ及 ＳＰＣＡ的 ＰＳＶ、ＥＤＶ、ＰＩ、ＲＩ两组比较均未见明显差异。结论眼外伤组ＣＲＡ血供降低是引起视功能障碍的重要原因之一,给临床对眼外伤的诊治和预后提供重要的依据。     

阴道彩超联合血清孕酮、β-HCG及CA125对异位妊娠的诊断价值

目的 探究阴道彩超检测子宫内膜厚度联合血清孕酮、β-HCG及CA125检测诊断异位妊娠的价值。方法 选取我院2016年5月~2018年5月收治的40例异位妊娠患者设为异位妊娠组,同期选取30例正常妊娠者设为对照组,选取30例宫内妊娠流产者设为自然流产组,比较阴道彩超、血清孕酮、β-HCG及CA125等指标,比较单项检测与联合检测诊断异位妊娠的检出率。结果 异位妊娠组及自然流产组血清孕酮、β-HCG及子宫内膜厚度低于对照组,而血清CA125水平高于对照组,差异均有统计学意义（P＜0.05）,异位妊娠组与自然流产组血清孕酮、β-HCG及子宫内膜厚度比较,差异无统计学意义（P＞0.05）,CA125水平高于自然流产组,差异有统计学意义（P＜0.05）;阴道彩超、血清孕酮、β-HCG、CA125单一检测异位妊娠的诊断率分别为72.50%、55.00%、52.50%、47.50%,低于联合检测的97.50%,差异有统计学意义（P＜0.05）。结论 采用阴道彩超检测子宫内膜厚度联合血清孕酮、β-HCG及CA125检测可提高异位妊娠的检出率,对早期异位妊娠诊断和治疗具有重要临床意义。     

多囊卵巢综合征患者血清瘦素和胰岛素检测的临床意义

目的:检测多囊卵巢综合征(polycystic ovary syndrome, PCOS)患者血清瘦素(leptin)及胰岛素(insulin)含量,以探讨leptin与PCOS的关系.方法:采用放射免疫分析检测34例PCOS患者及30例健康对照组血清中的leptin和insulin浓度.结果:PCOS患者血清中的leptin及insulin含量均高于健康对照组,且有高度显著性差异(P＜0.01);同时,PCOS患者中的肥胖组与非肥胖组相比二者也有高度显著性差异(P＜0.01),肥胖组高于非肥胖组.结论:血清leptin和insulin与PCOS可能有较好的相关性,提示血清leptin含量可作为PCOS患者的一项辅助诊断指标.     

Uterine effects of metformin administration in anovulatory women with polycystic ovary syndrome

BACKGROUND: Metformin has been shown to improve fertility in anovulatory patients with polycystic ovary syndrome (PCOS), inducing not only a high ovulation and pregnancy rate but also reducing the incidence of miscarriages. The aim of the present study was to evaluate the uterine effects of metformin in patients with PCOS who ovulated under metformin. METHODS: Thirty-seven non-obese primary infertile anovulatory patients with PCOS and another 30 age- and body mass index-matched healthy women (control group) were studied. PCOS patients were treated with metformin (850 mg twice daily) for 6 months, whereas the control group did not receive any treatment. In these PCOS patients who ovulated whilst under metformin treatment (PCOS group) and in controls, uterine, sub-endometrial and endometrial blood flow, and endometrial thickness and pattern were evaluated using serial ultrasonographic assessments. RESULTS: Before treatment, uterine, sub-endometrial and endometrial blood flows were significantly lower in patients with PCOS than in the control group. All indexes of uterine vascularization were significantly improved in the PCOS group with metformin treatment and were not different from the controls. Nor was any difference in endometrial thickness and pattern detected between PCOS and control groups. After grouping the data of PCOS patients who ovulated under metformin for cycles with favourable/unfavourable reproductive outcome, no difference in any parameter was observed. CONCLUSIONS: Metformin improves all surrogate markers of endometrial receptivity in PCOS patients, without difference between patients who had favourable or unfavourable reproductive outcome.     

Insulin resistance in women with hirsutism

Introduction

There are still not enough data showing whether patients with idiopathic hirsutism (IH) also have insulin resistance. The association between polycystic ovary syndrome (PCOS) and insulin resistance is well documented in the literature, but the Rotterdam Consensus has concluded that principally obese women with PCOS should be screened for the metabolic syndrome. We intended to investigate the presence/absence of insulin resistance in non-obese women with hirsutism.

Material and methods

Twenty-eight women with PCOS (14 non-obese and 14 obese), 12 non-obese with IH, and 16 non-obese healthy women were included in the study. The presence of insulin resistance was investigated by using basal insulin levels and the homeostasis model assessment (HOMA) score in the study group.

Results

Patients with obese and nonobese PCOS had significantly (p < 0.05) higher basal insulin levels and HOMA scores than IH and control subjects. Insulin levels and HOMA scores did not differ between obese and non-obese PCOS patients. Patients with IH did not show any difference from the control group.

Conclusions

Insulin resistance exists in non-obese women with PCOS as well as obese women with PCOS. The PCOS is associated with insulin resistance independent of obesity. Insulin resistance should be assessed in all hirsute women with PCOS regardless of their body mass index. More studies in larger numbers of patients should be performed to investigate the role of insulin resistance in women with IH.     

Endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in patients with small intramural uterine fibroids during IVF treatment

BACKGROUND: The impact of intramural fibroids on the success of IVF treatment is controversial and the mechanisms leading to poor treatment outcomes remain unknown. We compared endometrial and subendometrial blood flow between women with and without intramural fibroids during IVF treatment. METHODS: Three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval in 50 patients with intramural fibroids not distorting the uterine cavity and in 50 matched controls to measure endometrial thickness, uterine pulsatility index (PI)/resistance index (RI), endometrial volume and vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions. Smokers, patients with serum estradiol concentrations > or =20,000 pmol/l on the day of HCG and previous history of myomectomy were excluded. RESULTS: Endometrial thickness and pattern, averaged uterine PI and RI and endometrial and subendometrial VI/FI/VFI were similar between the fibroid group and the control group. There was no correlation between the total volume of fibroids and endometrial and subendometrial 3D power Doppler flow indices in the fibroid group. CONCLUSION: Endometrial and subendometrial 3D power Doppler flow indices were similar in patients with and without small intramural fibroids.     

Raloxifene therapy does not affect uterine blood flow in postmenopausal women: a transvaginal Doppler study

OBJECTIVE: To monitor the effects of raloxifene therapy on the uterus of postmenopausal women by transvaginal ultrasonography and color flow Doppler. Methods: Twenty-five healthy postmenopausal women were enrolled in this prospective longitudinal study performed at Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeir?o Preto. The patients were treated with raloxifene hydrochloride (60 mg per day) for 6 months. All were submitted to transvaginal ultrasound examination with color flow Doppler (ATL-HDI 3000 equipment) before the beginning and after 1, 3 and 6 months of treatment. Resistance index (RI) and pulsatility index (PI) of the uterine arteries were determined by the Doppler method, being considered as indicators of uterine perfusion. The following variables were analyzed: endometrial thickness, uterine volume, RI, and PI. Data were analyzed statistically by repeated-measures analysis of variance. RESULTS: Before treatment, endometrial thickness was 3.38 +/- 0.73 mm, and similar values were observed after 1, 3 and 6 months of treatment (3.04 +/- 0.82; 3.3 +/- 0.83; and 3.37 +/- 0.79, respectively) (P > 0.05). No significant differences in uterine volume were observed between the pre- and post-treatment periods. Uterine artery perfusion as indicated by RI and PI measured by Doppler also showed no significant variation, with a high impedance flow being maintained throughout treatment. CONCLUSIONS: In the group studied here, raloxifene treatment at the dose of 60 mg per day for 6 months did not induce significant changes in endometrial thickness, uterine volume or uterine artery perfusion, confirming that short-term raloxifene treatment does not affect the uterus of postmenopausal women.