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目的:探讨多囊卵巢综合征(PCOS)患者阴道彩色多普勒超声的影像学变化及其阴道彩色多普勒超声在PCOS诊断中的价值。方法:选取妇科门诊根据临床症状及性激素水平诊断为PCOS的患者40例为研究对象(PCOS组),将根据体重指数分为非肥胖组(16例,BMI<25 kg/m2)及肥胖组(24例,BMI≥25 kg/m2),随机选取同期门诊行阴道彩色多普勒超声检查的输卵管因素所致不孕的患者40例为对照组,行阴道超声多普勒超声检查。结果:PCOS患者髓质可见血流信号表现为收缩期上升快、下降缓慢,波峰圆钝,在间质血流信号以粗条状多见,血流频谱呈现高速低阻表现,舒张末期血流速度(EDV)、手术期峰值血流速度(PSV)值升高,卵巢体积增大,卵泡数目10个以上,LH值及LH/FSH值明显升高,对照组则表现为波峰较为尖锐,间质血流信号以星点状多见,EDV、PSV明显低,卵巢体积正常大小,卵泡数目以5~8个多见;两组患者在LH值、LH/FSH值、PI、RI、EDV、PSV、卵巢体积、卵泡数目、不同血流信号方面比较,差异有统计学意义(P<0.05),非肥胖组与肥胖组患者LH值、LH/FSH值、搏动指数(PI)、阻力指数(RI)、EDV、PSV、卵巢体积、卵泡数目、不同血流信号方面比较,差异无统计学意义(P>0.05)。结论:经阴道彩色多普勒超声可通过观察血流动力学变化提高PCOS的诊断水平。
Objective: To investigate the imaging changes of vaginal color Doppler ultrasonography in patients with polycystic ovary syndrome (PCOS) and the value of vaginal color Doppler ultrasonography in the diagnosis of PCOS. Methods: Forty patients with PCOS who were diagnosed as PCOS according to their clinical symptoms and sex hormone levels were selected as study objects (PCOS group), and were divided into non-obese group (16 cases, BMI <25 kg / m2) and obesity group 24 cases with BMI≥25 kg / m2). 40 patients with infertility caused by fallopian tube were examined by vaginal color Doppler ultrasonography in the same period. The control group received vaginal ultrasound Doppler ultrasonography. Results: The medullary signs of PCOS showed that systolic phase increased rapidly, decreased slowly, peaked blunt. The signals of interstitial blood flow were more common in thick strips, and the blood flow spectrum showed high-speed and low-resistance. The end-diastolic blood flow EDV, peak PSV, ovarian volume increased, the number of follicles was more than 10, the LH and LH / FSH values were significantly increased, while the control group showed the peak was more sharp The quality of blood flow signal was more common in the form of star, EDV, PSV was significantly lower, the normal size of ovarian volume, the number of follicles to 5-8 more common; two groups of patients in the LH value, LH / FSH value, PI, RI, EDV, PSV, ovarian volume, the number of follicles and different blood flow signals (P <0.05). The values of LH, LH / FSH, PI and resistance index in non-obese group and obesity group RI), EDV, PSV, ovarian volume, number of follicles, different blood flow signals, the difference was not statistically significant (P> 0.05). Conclusion: Transvaginal color Doppler ultrasound can improve the diagnosis of PCOS by observing hemodynamic changes.