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目的:定量分析多囊卵巢综合征(PCOS)患者卵巢动脉全脉动周期血流量的改变,探讨脉冲多普勒频谱定量评估卵巢动脉血流量的方法。方法:对80例PCOS患者分别于月经周期的第3~9天、11~15天、18~23天和26~32天应用经阴道彩色多普勒超声(TV-CDFI)进行卵巢动脉探查,观察并测定卵巢动脉收缩期峰值流速(Vs)、舒张末期流速(Vd)、血流速度-时间积分(VTI)及血流阻力指数(RI)。采用M型超声测量卵巢动脉内径值,运用VTI计算卵巢动脉全脉动周期血流量,并与正常组(80例)进行对照分析。结果:PCOS患者典型的卵巢动脉血流频谱表现为高速低阻波形图,血流量在月经周期的不同时间段内比较差异无统计学意义(P>0.05);RI在月经周期的不同时间段内的变化无统计学意义(P>0.05)。对照组血流量在月经周期的不同时间段内的变化明显,差异有统计学意义(P<0.05)。同样,RI在月经周期的不同时间段内的变化也有统计学意义(P<0.05)。PCOS患者血流量较对照组血流量明显升高,差异有统计学意义(P<0.05)。PCOS患者卵巢动脉在月经第3~9天以及26~32天时的RI低于对照组,差异有统计学意义(P<0.05)。两组RI在月经第11~15天以及18~32天时的差异无统计学意义(P>0.05)。结论:PCOS患者的卵巢特点之一是血管扩张、血流量增多。运用全脉动周期血流量计算公式对卵巢动脉血流量的定量测定可以提供一种相对准确、可靠的定量评估指标,反映PCOS患者卵巢的血流灌注情况。
OBJECTIVE: To quantitatively analyze the changes of total circulatory flow in ovarian artery in patients with polycystic ovary syndrome (PCOS) and to evaluate the method of quantitative assessment of ovarian artery blood flow by pulsed Doppler spectroscopy. Methods: Eighty PCOS patients were examined by transvaginal color Doppler ultrasonography (TV-CDFI) on the 3rd to 9th, 11th to 15th, 18th to 23th, and 26th to 32nd day of the menstrual cycle. The peak systolic velocity (Vs), end diastolic velocity (Vd), blood flow velocity-time integral (VTI) and blood flow resistance index (RI) were observed and measured. The diameter of the ovarian artery was measured by M-mode ultrasound and the whole-cycle blood flow of the ovarian artery was calculated by VTI and compared with the normal group (80 cases). Results: The frequency spectrum of typical ovarian artery in patients with PCOS showed a high-speed low-resistance waveform. There was no significant difference in blood flow between different periods of the menstrual cycle (P> 0.05). RI was found in different periods of the menstrual cycle The changes were not statistically significant (P> 0.05). The changes of blood flow in control group in different periods of menstrual cycle were significant (P <0.05). Similarly, changes in RI during different periods of the menstrual cycle were also statistically significant (P <0.05). The blood flow of patients with PCOS was significantly higher than that of the control group, the difference was statistically significant (P <0.05). The RI of PCOS patients in the 3rd to 9th and 26th to 32nd days of menstruation was significantly lower than that in the control group (P <0.05). There was no significant difference in RI between the two groups on days 11-15 and 18-32 (P> 0.05). Conclusion: One of the ovarian characteristics of patients with PCOS is vasodilation and blood flow increase. Quantitative determination of ovarian arterial blood flow using the formula of full pulsation cycle blood flow can provide a relatively accurate and reliable quantitative evaluation index to reflect the blood perfusion in the ovary of PCOS patients.