| 徐子宁,姚洁,廉华,赵宏利,马娴.经阴道三维能量多普勒超声评估35岁以内卵巢储备功能下降患者的卵巢血流灌注[J].浙江中西医结合杂志,2018,28(6): |
| 经阴道三维能量多普勒超声评估35岁以内卵巢储备功能下降患者的卵巢血流灌注 |
| Evaluation on dominant ovarian vascularization with ovarian reserve decline in women under 35 years old by using transvaginal three-dimensional power Doppler ultrasound |
| 投稿时间：2017-09-07 修订日期：2017-11-13 |
| DOI： |
| 中文关键词: 经阴道三维能量多普勒超声 卵巢储备功能 |
| 英文关键词:[Key words] Three-dimensional power Doppler ultrasound Ovarian reservation |
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| 中文摘要: |
| [摘要]目的 探讨应用经阴道三维能量多普勒超声（TVS-3D-PDA）获取的卵巢间质血管形成指数（VI）、血流指数（FI）、血管形成血流指数（VFI）对23-35岁卵巢储备功能下降（DOR）患者优势卵巢的血流灌注评估价值。方法 50例23-35岁女性，依据基础卵泡刺激素（bFSH）、基础卵泡刺激素/基础黄体生成素（bFSH/bLH）、抗苗勒管激素（AMH）和窦卵泡计数（AFC）结果分为卵巢储备功能正常组(NOR)和卵巢储备功能下降组(DOR)；依据卵泡监测结果确定优势卵巢，应用TVS-3D-PDA分别于早卵泡期（月经周期第2-4天）和晚卵泡期（出现直径≥16mm的优势卵泡时至排卵前）获取双侧卵巢间质VI、FI、VFI。结果 早卵泡期优势卵巢FI与AMH、AFC呈显著正相关（r=0.734,p=0.000;r=0.775,p=0.000)，与bFSH/bLH、bFSH呈显著负相关（r=－0.830,p=0.000；r=－0.777,p=0.000）。早卵泡期优势卵巢的DOR组和NOR组的FI有统计学差异（P<0.05），晚卵泡期优势卵巢的DOR组和NOR组VI、 FI、VFI均有统计学差异（P<0.05;0.01;0.01）。结论 早卵泡期优势卵巢VI、 FI、VFI中，FI与AMH、AFC、bFSH/bLH、 bFSH相关性良好，对卵巢储备评估价值最佳。优势卵巢的早卵泡期FI值，晚卵泡期VI、 FI、VFI值，以及VI、VFI在整个卵泡期的增长幅度可能有助于DOR的早期筛选，动态测定卵泡期优势卵巢间质VI、FI、VFI能更好评价血流灌注，评估卵巢储备功能（OR）。 |
| 英文摘要: |
| Evaluation on the young women’s dominant ovarian vascularization with ovarian reserve decline using transvaginal three-dimensional power Doppler ultrasound
Xu Zi-ning1 , Xu Sen-yin1, TU Mei-lin1, Peng Cheng-zhong1, Yao Jie1, Lian hua1，Zhao Hong-li2, Ma xian2 , Xia Wen-xia1, Li Min1, Chen Lin-li1, Lu Chao1
(1 Department of Ultrasound， 2 Department of traditional Chinese gynecology，Hangzhou TCM hospital, The Second Affiliated Hospital of Hangzhou normal university, Hangzhou 310007，China)
[ABSTRACT] Objective To explore the value of ovary stromal vascular indices: vascularization index (VI)、flow index (FI) and vascularization flow index (VFI) which obtained by transviginal three dimensional power Doppler ultrasound(TVS-3D-PDA) in evaluating the dominant ovarian vascularization with ovarian reserve decline. Methods 50 cases of women, 23-35 years old, are divided into two groups of ovarian reserve normal and ovarian reserve decline according to basal levels of t sex hormone determination and antral follicle counts(AFC)；the dominant ovaries have been confirmed according to the results of follicular monitoring. Both ovaries stromal vascular indices including VI、FI、VFI have been acquired on cycle day 2, 3 or 4, and late follicular phase as well, using TVS-3D-PDA. Result The dominant Ovary stromal vascular index FI in early follicular phase has significant positive correlation with AMH and AFC（r=0.734, p<0.01; r=0.775,p<0.01）,respectively, and has significant negative correlation with bFSH/bLH and bFSH（（r=－0.830,p=0.000; r=－0.777,p=0.000）,respectively. The dominant ovary stromal vascular index FI in early follicular phase between DOR and NOR has statistics difference(P<0.05),and the dominant Ovary stromal vascular indices VI, FI, VFI in late follicular phase between DOR and NOR all have statistics differences（P<0.05、0.01、0.01）,respectively. Conclusions The dominant ovary stromal vascular index FI in early follicular phase has good correlation with AMH、AFC、bFSH/bLH、 bFSH, it can be supposed to be the most valuable index in evaluating ovarian reservation compared with VI and VFI. The dominant Ovary stromal vascular index FI in early follicular phase; VI, FI, VFI in late follicular phase; and the growth rate of VI,VFI during the whole follicular phase may have contribution on screening DOR more earlier. In all，analyzing ovary stromal vascular index VI,FI,VFI dynamically can evaluate the vascularization more better, and ovarian reservation the same. |
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