不同表现多囊卵巢综合征超声参数与内分泌指标的相关性研究

摘要

Objective To study the relationship of three-dimensional power Doppler ultrasonographic parameters and endocrine profile in different symptoms of patients with polycystic ovary syndrome(PCOS).Methods One hundred and forty nine women with PCOS were divided into two groups,which included obese PCOS(OB-PCOS) group and non-obese PCOS (NOB-PCOS) group.The ultrasonic parameters such as follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,vascularization index(Ⅵ),flow index(FI),vascularization flow index(VFI) were measured and compared.Serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),progesterone (P),estradiol (E2),testosterone(T),prolactin (PRL),sex hormone binding globulin (SHBG),free androgen index (FAI),fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment-IR(HOMA-IR) were also measured and compared.The correlation of the ultrasonic parameters and hormonal factors were analyzed.Results The follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,FI and VFI,FINS,HOMA-IR,FAI of OB-PCOS were significantly higher than those of NOB-PCOS (P ＜0.01 or 0.05),the FSH,SHBG were significantly lower than those of NOB-PCOS (P ＜0.05 or 0.01).In OB-PCOS group,the follicle number was significantly associated with FSH(r =0.771,P ＜0.01).The ovarian volume,stromal volume,FI and VFI were significantly associated with HOMA-IR(r =0.412,0.842,0.389,0.415,P ＜0.05 or 0.01),FI was significantly associated with FAI (r =0.812,P ＜0.01).In NOB-PCOS group,the follicle number,ovarian volume were significantly associated with FAI(r =0.472,0.552,P ＜0.05)..Conclusions There are some different characters in ultrasonography and endocrine parameters between obese and non-obese PCOS patients.%目的 比较不同临床表现的多囊卵巢综合征(PCOS)患者超声参数与内分泌指标特征.方法 将149例PCOS患者分为肥胖型PCOS组(OB-PCOS组)和非肥胖型PCOS组(NOB-PCOS组),测量并比较两组卵泡数、平均卵巢直径、卵巢体积、间质体积和卵泡体积以及血管化指数(Ⅵ)、血流指数(FI)、血管化-血流指数(VFI).检测并比较两组黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)、雌二醇(E2)、总睾酮(T)、泌乳素(PRL)、性激素结合球蛋白(SHBG)、游离雄激素指数(FAI)、血糖(FPG)、血浆胰岛素(FINS)、稳态模型指数(HOMA-IR).分析超声参数和内分泌指标的相关性.结果 OB-PCOS组卵巢直径、卵泡数、卵巢体积、间质体积、卵泡体积、FI和VFI、FINS、HOMA-IR、FAI较NOB-PCOS组增大,FSH、SHBG较NOB-PCOS组降低,差异有统计学意义(P＜0.05或0.01).OB-PCOS组卵泡数与FSH呈正相关(r=0.771,P＜0.01),卵巢体积、间质体积、FI、VFI与HOMA-IR呈正相关(r分别为0.412、0.842、0.389、0.415,P＜0.05或0.01),FI与FAI呈正相关(r=0.812,P＜0.01).在NOB-PCOS组中,患者卵巢卵泡数与FAI呈正相关(r=0.472,P＜0.05),卵巢体积与FAI呈正相关(r=0.552,P＜0.05).结论 肥胖型与非肥胖型PCOS有不同的超声参数和内分泌指标特征.