超声评估子宫内膜下的RI、PI、PSV值预测不孕患者子宫内膜状况及卵巢储备功能的研究

doi:10.3969/j.issn.1007-3205.2023.09.011

河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (9): 1047-1052.doi: 10.3969/j.issn.1007-3205.2023.09.011

超声评估子宫内膜下的RI、PI、PSV值预测不孕患者子宫内膜状况及卵巢储备功能的研究

1.河北省邢台市第三医院产科，河北邢台 054000;2.河北省邢台市妇幼保健院产科,河北邢台 054000;3.河北省秦皇岛市海港医院产科，河北秦皇岛 066022

出版日期:2023-09-25 发布日期:2023-10-12
作者简介:樊秀梅(1982-)，女，河北邢台人，河北省邢台市第三医院主治医师，医学学士，从事不孕不育症诊治研究。
基金资助:
河北省医学科学研究课题计划(20221624)

Ultrasonographic evaluation of subendometrial RI, PI and PSV values in the prediction of endometrial status and ovarian reserve function in infertile patients

1.Department of Obstetrics,the Third Hospital of Xingtai City, Hebei Province, Xingtai 054000, China;
2.Department of Obstetrics, Xingtai Maternal and Child Health Care Hospital,Hebei Province, Xingtai
054000, China; 3.Department of Obstetrics, Qinhuangdao Harbor Hospital,Hebei Province,
Qinhuangdao 066022, China

Online:2023-09-25 Published:2023-10-12

摘要/Abstract

摘要： 目的探讨超声评估子宫内膜下的阻力指数（resistance index，RI）、搏动指数（pulsatility index，PI）、收缩期峰值血流速度（peak systolic blood flow velocity，PSV）值对不孕患者子宫内膜状况及卵巢储备功能的预测价值。
方法纳入女性不孕症患者140例作为观察组（卵巢功能正常者83例，卵巢功能异常者57例），另选取同期健康已生育女性100例作为对照组。2组均行经阴道多普勒超声检查，测量子宫内膜下的RI、PI和PSV值，同时观察子宫内膜情况。采用Pearson相关性分析RI、PI、PSV值与子宫内膜情况的相关性，并通过受试者工作曲线（receiver operating curve，ROC）分析RI、PI、PSV值对不孕症患者卵巢储备功能的预测效能。
结果观察组子宫动脉的PI值和RI值高于对照组，PSV值低于对照组（P＜0.05）。观察组子宫内膜容积和B型、C型子宫内膜类型例数占比高于对照组，子宫内膜厚度低于对照组（P＜0.05）。相关性分析结果显示，PI和RI值均与子宫内膜厚度呈负相关，与子宫内膜容积和子宫内膜类型呈正相关；PSV值与子宫内膜厚度呈正相关，与子宫内膜容积和子宫内膜类型呈负相关（P＜0.05）。卵巢功能正常组子宫动脉的RI、PI值低于卵巢功能异常组,PSV值高于卵巢功能异常组（P＜0.05）。ROC结果显示，RI、PI和PSV值预测不孕者卵巢功能的AUC分别为0.648（0.518~0.777）、0.715（0.595~0.835）和0.807（0.736~0.922），敏感度分别为62.51%、62.48%和81.21%，特异度分别为75.04%、65.08%和72.52%；三项指标联合诊断的AUC为0.905（0.878~0.984），敏感度为84.43%，特异度为87.56%；联合检测对不孕症患者卵巢储备功能的诊断效能优于单项检测。
结论女性不孕症和健康女性的子宫内膜下RI、PI及PSV值存在明显差异，通过超声评估测量RI、PI及PSV值可有效预测不孕患者的子宫内膜状况和卵巢储备功能，三项参数联合预测价值更高。

关键词: 不育,女性, 子宫内膜, 卵巢储备功能, 超声检查

Abstract: Objective To investigate the value of ultrasonographic evaluation of subendometrial resistance index (RI), pulsatility index (PI) and peak systolic blood flow velocity (PSV) values in predicting endometrial status and ovarian reserve function (ORF) in infertile patients.
Methods A total of 140 female infertile patients were included as the observation group (83 cases with normal ovarian function and 57 cases with abnormal ovarian function), and 100 healthy women who had given birth during the same period were selected as the control group. Transvaginal Doppler ultrasonography was performed in both groups to measure the values of subendometrial RI, PI and PSV and observe the endometrium simultaneously. Pearson correlation was used to analyze the correlation between RI, PI and PSV values and endometrial conditions, and the predictive efficacy of RI, PI and PSV values on ORF in infertile patients was analyzed by receiver operating characteristic (ROC) curve.
Results The PI and RI values of uterine artery in observation group were higher than those in control group, while the PSV values were lower than those in control group (P＜0.05). The endometrial volume and the number of B-type and C-type endometrium in the observation group were higher than those in the control group, while the endometrial thickness was lower than that in the control group (P＜0.05). Correlation analysis showed that PI and RI values were negatively correlated with endometrial thickness, but positively correlated with endometrial volume and endometrial type. PSV value was positively correlated with endometrial thickness and negatively correlated with endometrial volume and endometrial type (P＜0.05). The RI and PI values of uterine artery in the normal ovarian function group were lower than those in the abnormal ovarian function group, and the PSV values were higher than those in the abnormal ovarian function group (P＜0.05). ROC results showed that the area underthe ROC curve (AUC) of RI, PI and PSV values in predicting ovarian function in infertile patients were 0.648 (0.518-0.777), 0.715 (0.595-0.835) and 0.807 (0.736-0.922), respectively; the sensitivity were 62.51%, 62.48% and 81.21%, respectively, and the specificity was 75.04%, 65.08% and 72.52%, respectively. The AUC of combined diagnosis was 0.905 (0.878-0.984), the sensitivity was 84.43%, and the specificity was 87.56%. The diagnostic efficacy of combined detection for ORF in infertile patients was superior to that of single detection.
Conclusion 〖JP2〗There are significant differences in the values of subendometrial RI, PI and PSV values between women with infertility and healthy women. The ultrasonographic evaluation of RI, PI and PSV values can effectively predict the endometrial status and ORF of infertile patients, and the combined detection of the three parameters has a higher predictive value.

Key words: infertility, female, endometrium, ovarian reserve function, ultrasonography

樊秀梅, 杨丽, 赵岗, 霍森烨, 冷慧敏. 超声评估子宫内膜下的RI、PI、PSV值预测不孕患者子宫内膜状况及卵巢储备功能的研究 [J]. 河北医科大学学报, 2023, 44(9): 1047-1052.

FAN Xiu-mei, YANG Li, ZHAO Gang, HUO Sen-ye, LENG Hui-min. Ultrasonographic evaluation of subendometrial RI, PI and PSV values in the prediction of endometrial status and ovarian reserve function in infertile patients [J]. Journal of Hebei Medical University, 2023, 44(9): 1047-1052.

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超声评估子宫内膜下的RI、PI、PSV值预测不孕患者子宫内膜状况及卵巢储备功能的研究

Ultrasonographic evaluation of subendometrial RI, PI and PSV values in the prediction of endometrial status and ovarian reserve function in infertile patients

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