卵巢超声特征联合内分泌指标在不同类型多囊卵巢综合征应用价值分析

摘要

目的 研究卵巢超声特征联合内分泌指标在胰岛素抵抗型与非胰岛素抵抗型多囊卵巢综合征中的应用价值.方法 选取2013年2月-2015年3月于本院就诊的共218例多囊卵巢综合征患者作为研究对象.采用HOMA-IR标准进行分组,HOMA-IR ≥2.69的115例为胰岛素抵抗组;HOMA-IR＜ 2.69的103例者为非胰岛素抵抗组.同时选取同期进行健康体检者69例作为对照组.检测卵巢超声特征,包括卵巢包膜厚度、卵巢直径、卵泡最大直径、OV、卵泡体积、卵泡数、血流指数.检测内分泌指标,包括FSH、LH、LH/FSH、E2、T、PRL、FINs、FPG、SHBG.结果 胰岛素抵抗组和非胰岛素抵抗组卵巢包膜厚度、OV、卵巢直径、卵泡体积、卵泡数、血流指数大于对照组,卵泡最大直径小于对照组,且差异均有统计学意义(P＜0.05);胰岛素抵抗组的OV、卵巢直径、卵泡体积、卵泡数目、血流指数大于非胰岛素抵抗组,卵泡最大直径小于非胰岛素抵抗组,且差异均有统计学意义(P＜0.05);胰岛素抵抗组和非胰岛素抵抗组LH、LH/FSH、FSH、FINs及T大于对照组,SHBG、E2小于对照组,且差异均有统计学意义(P＜0.05);胰岛素抵抗组的FPG大于对照组,且差异具有统计学意义(P＜0.05);胰岛素抵抗组的T、FINs大于非胰岛素抵抗组,胰岛素抵抗组SHBG小于非胰岛素抵抗组,且差异有统计学意义(P＜0.05).单因素相关性分析显示,OV与LH/FSH、T、BMI、HOMA-IR呈正相关(r=0.255,0.267,0.534,0.427,P＜0.05),卵泡最大直径约T、HOMA-IR、BMI呈负相关(r=-0.426,-0.433,-0.317,P＜0.05).卵泡刺激素与卵泡数呈正相关(r=0.817,P＜0.05).结论 胰岛素抵抗型多囊卵巢综合征患者卵泡最大直径减小,OV增大.OV与LH/FSH、T、BMI、HOMA-IR呈正相关,卵泡最大直径约T、HOMA-IR、BMI呈负相关.卵泡刺激素与卵泡数呈正相关.%Objective To analyze the value of ovary ultrasonic features and endocrine indicators in patients with polycystic ovary syndrome.Methods A total of 218 polycystic ovary syndrome between February 2013 and March 2015 were selected as research objects.And they were divided into HOMA-IR insulin resistance group (n =115) with HOMA-IR more than 2.69,and non insulin resistance group (n =103 cases) with HOMA-IR less than 2.69.And another 69 healthy people were selected in the same period as control group.The ovary ultrasonic features such as ovarian capsule thickness,ovary diameter,maximum diameter of follicle,OV,follicular volume,follicle count,flow indicators were checked.And the endocrine indicators such as FSH,LH,LH/FSH,E2,T,PRL,FINs,FPG,SHBG were determined.Results The ovarian capsule thickness,OV,ovary diameter,follicular volume,follicle count,flow indicators of insulin resistance group and non insulin resistance group were more than control group (P ＜ 0.05).The OV,ovary diameter,follicular volume,follicle count,flow indicators of insulin resistance group were more than non insulin resistance group,maximum diameter of follicle was less than non insulin resistance group (P ＜ 0.05).The LH,LH/FSH,FSH,FINs and T of insulin resistance group and non insulin resistance group were more than that of controlgrouD (P ＜ 0.0 5).SHBG and E2 were less than control group (P ＜ 0.0 5).FPG of insulin resistance group was more than control group (P ＜ 0.0 5).The T and FINs of insulin resistance group were more than non insulin resistance group (P ＜ 0.05).The SHBG of insulin resistance group was less than non insulin resistance group (P ＜ 0.05).Single factor correlation analysis showed that OV was positively correlated with LH/FSH,T,BMI and HOMA-IR(r =0.255,0.267,0.534,0.427,P ＜0.05),maximum diameter of follicle was negatively correlated with T,HOMAIR,BMI (r =-0.426,-0.433,-0.317,P ＜ 0.05).FSH was positively correlated with follicle count (r =O.817,P ＜ 0.05).Conclusion The maximum diameter of follicle is decreased,and OV is magnified of insulin resistance type of polycystic ovary syndrome.OV is positively correlated with LH/FSH,T,BMI and HOMA-IR.Maximum diameter of follicle is negatively correlated with T,HOMA-IR,and BMI.FSH was positively correlated with follicle count.