多囊卵巢综合征患者多普勒超声测量参数与性激素、炎性因子水平的相关性分析.pdf
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1、CorrT临床研究。594BME&ClinMed,eptember2023,Vol.27,No.5生物医学工程与临床2 0 2 3年9 月第2 7 卷第5期网络出版时间:2 0 2 3-0 8-2 2 17:0 4:33D0I:10.13339/j.c n k i.s g l c.2 0 2 30 8 2 2.0 15网络出版地址:https:/ 0 例(病例组),年龄2 335岁,平均年龄30.6 9 岁。另取同期在医院体检健康女性10 0 例(对照组),年龄2235岁,平均年龄30.2 5岁。给予两组多普勒超声检查,测量两组子宫、卵巢血流参数 阻力指数(RI)、搏动指数(PI),并取肘静脉
2、血检测其性激素 雌二醇(E2)、促卵泡激素(FSH)、促黄体生成素(LH)、睾酮(T)及炎性因子 肿瘤坏死因子(TNF)-、白细胞介素6(IL-6)、内皮抑素(ES)水平,分析PCOS 患者多普勒超声血流参数与其血清炎性因子、性激素水平的相关性。结果两组超声参数比较,病例组子宫RI、PI显著高于对照组(0.8 9 0.14us0.810.12、2.8 7 0.2 6 v s2.140.21。P 0.0 5),卵巢RI、PI显著低于对照组(0.430.0 7 vs0.620.12、0.7 30.11v s 0.9 10.14。P 0.0 5)。病例组血清LH、T 水平显著高于对照组(9.331.
3、6 4)U/Lvs(4.59 1.0 2)U/L、(1.140.13)n g/mLv s(0.6 10.0 8)n g/mL。P0.05,FSH水平显著低于对照组(6.311.0 2 U/Lus(8.9 6 1.2 8)U/L。P0.05)。病例组血清TNF-、IL-6、E S 均显著高于对照组 2 0.9 53.0 5)ng/mLvs(12.52 2.51)n g/mL、(12.541.57)n g/mLv s(6.331.05)p g/mL、2 34.2 516.33)g/Lvs(156.9 7 17.0 5)g/L。P 0.0 5。PC O S 患者子宫RI、PI与患者LH、T 水平正相
4、关(r=0.531、0.433、0.37 1、0.40 7,均P0.05),与FSH水平负相关(r=-0.963、-1.0 8 1,P 0.0 5);卵巢RI、PI与患者血清LH、T 水平负相关(r=-2.082、-1.2 14、-1.530、-1.0 9 4,均P0.05),与FSH水平正相关(r=0.392、0.58 3,均P0.05);PCOS患者子宫RI、PI与血清TNF-、IL-6、E S 均为正相关(r=0.364、0.56 1、0.38 5、0.2 6 9、0.312、0.40 5,均P0.05),卵巢RI、PI与血清TNF-、IL-6、E S 均为负相关(r=-2.634、-3
5、.39 7、-1.48 2、-0.39 8、-1.433、-2.317,均P0.05)。结论PCOS患者普遍存在子宫及卵巢血流动力学异常,并伴有炎性因子及部分性激素水平高表达,其子宫、卵巢多普勒超声参数与性激素、炎性因子水平具有相关性,关键词:多囊卵巢综合征;多普勒超声;性激素;炎性因子;相关性分析中图分类号:R711.75;R445.1文献标识码:A文章编号:10 0 9-7 0 9 0(2 0 2 3)0 5-0 59 4-0 5Correlation analysis of Doppler ultrasonography parameters with serum levels of s
6、ex hormones and inflammatorCorrelation analysis of Doppler ultrasonography parameters with serum levels of sex hormones and inflammatoryfactors inpatients with polycystic ovary syndromeZHAO Fang-yuan,ZOU Hong,SHI Si-maob,XU Fangb(afactors in patients with polycystic ovary syndromeZHAO Fang-yuan,ZOU
7、Hong,SHI Si-maob,XU Fangh(a.DepartmentofIlltrondMedicine:b.DeparttofCTheFirstAffiliated Hospital of HeilonsIniversPOyCaiigyuanr11011811aoAo1agepartment of Ultrasound Medicine;b.Department of Gynecology,The First Affliated Hospital of Heilongjiang University ofraditional Chinese Medicine,Harbin150040
8、,Heilongjiang,China)esponding author:XU Fang.E-mail:.Abstract:Objective To explore the correlation between Doppler ultrasound measurement parameters and serum levels of sexhormones and inflammatory factors in patients with polycystic ovary syndrome(PCOS).Methods A total of 120 patients withPCOS were
9、 enrlled as case group,which aged 23-35 years old with mean age of 30.69 years old.At the same period,100healthy examined females were set as control group,aged 22-35 years old with mean age of 30.25 years old.All of them per-formed Doppler ultrasonography to measure uterine and ovarian blood flow p
10、arametersresistance index(RI),pulsatility index(PI),and underwent elbow venous blood examination to detect serum levels of sex hormoneestradiol(E2),follicle stimulatinghormone(FSH),luteinizing hormone(LH),testosterone(T)and inflammatory factorstumor necrosis factor(TNF)-,interleukin-6(IL-6),endostat
11、in(ES)levels.The correlation between Doppler ultrasound blood flow parameters and serum inflammatory factorsas well as sex hormone levels in PCOS patients was analyzed.Results The uterine RI and PI in case group were significantlyhigher than those in control group(0.89 0.14 us 0.81 0.12,2.87 0.26 vs
12、 2.14 0.21.P 0.05),while ovarian RI and PI incase group were significantly lower than in control group(0.43 0.07 vs 0.62 0.12,0.73 0.11 vs 0.91 0.14.P0.05).Thelevels of serum LH and T in case group were significantly higher than those in control group(9.33 1.64)U/L us(4.59 1.02)U/L,作者单位:黑龙江中医药大学附属第一
13、医院a.超声医学科;b.妇科,黑龙江哈尔滨150 0 40作者简介:赵芳园(19 8 2),女,黑龙江省人,硕士,主治医师,主要从事妇科超声诊断与治疗工作。电话:158 46 6 2 0 0 7 7。E-mail;。基金项目:黑龙江省中医药科研项目(2 0 18-0 6 4);国家自然科学基金资助项目(8 2 0 0 440 1)通信作者:徐芳(19 8 1),女,黑龙江尚志市人,博士,副主任医师,主要从事妇科疾病治疗工作。电话:150 8 46 6 2 7 18。E-mail:x u 150 8 46 6 2 7 18 16 o版权保护,不得翻录。595-生物医学工程与临床2 0 2 3年9
14、 月第2 7 卷第5期BME&ClinMed,September2023,Vol.27,No.5(1.14 0.13)ng/mL vs(0.61 0.08)ng/mL.P 0.05,while FSH level of in case group was significantly lower than that ofcontrol group(6.31 1.02)U/L vs(8.96 1.28)U/L.P 0.05).The serumlevels of TNF-,IL-6 and ES in case group were significantly higher than those
15、in control group(20.95 3.05)ng/mL vs(12.52 2.51)ng/mL,(12.54 1.57)pg/mL vs(6.33 1.05)pg/mL,(234.25 16.33)g/L vs(156.97 17.05)g/L.P 0.05).The uter-ine RI and PI of PCOS patients were positively significantly correlated with LH and T levels(r=0.531,0.433,0.371,0.407,P0.05),and were negatively signific
16、antly correlated with FSH level(r=-0.963,-1.081.P 0.05).In PCOS patients,the ovarianRI and PI were negatively correlated with serum LH and T levels(r=-2.082,-1.214,-1.530,-1.094.P 0.05),and was posi-tively correlated with serum FSH level(r=0.392,0.583.P 0.05).The uterine RI and PI were positively co
17、rrelated with serumTNF-,IL-6 and ES in PCOS patients(r=0.364,0.561,0.385,0.269,0.312,0.405.P 0.05),ovarian RI and PI were negativelycorrelated with serum TNF-,IL-6 and ES(r=-2.634,-3.397,-1.482,-0.398,-1.433,-2.317.P0.05)。医院伦理委员会已批准此次研究(批号:201904-09)。1.2方法1.2.1多普勒超声检查应用美国GE公司生产的Voluson-E10彩色多普勒超声系统进
18、行超声诊断,探头频率设置为7.5MHz。研究对象取仰卧位接受检查,经阴道探查,探头缓慢推人阴道,对其卵巢间质中及子宫峡部两侧最强血流信号进行检测。计算子宫、卵巢动脉阻力指数(resis-tance index,RI)及搏动指数(pulsatility index,PI)。1.2.2性激素及炎性因子水平检测于清晨空腹状态采集肘静脉血4mL。离心分离血清(转速30 0 0 r/min,时间15min),利用酶联免疫吸附分析(enzyme-linked immunosorbent assay,ELISA)法测量炎性因子 TNF-、IL-6、E S)及性激素 雌二醇(estradiol,E2)、促卵泡
19、激素(follicle stimulating hor-mone,FSH)、促黄体生成素(luteining hormone,LH)、睾酮(testosterone,T)水平。相关试剂盒均购自中国武汉菲恩生物科技有限公司,检测步骤严格按照试剂盒上操作说明进行。596-BME&ClinMed,September 2023,Vol.27,No.5生物医学工程与临床2 0 2 3年9 月第2 7 卷第5期1.2.3观察指标比较两组子宫及卵巢RI、PI 及血清炎性因子(TNF-、IL-6、E S)、性激素(LH、F S H、T、E 2)水平,并对各多普勒超声血流参数与血清炎性因子、性激素的相关性进行分
20、析。1.3统计学方法使用SPSS24.0软件分析数据。血流参数、炎性因子及性激素水平等计量资料符合正态分布,以均数标准差表示,组间比较行独立样本t检验。血流参数与血清炎性因子、性激素水平相关性分析采用Pear-son 相关性分析。P0.05为差异有统计学意义,P0.01为差异有显著统计学意义。2结果2.1两组超声血流参数对比病例组子宫RI、PI显著高于对照组,卵巢 RI、PI显著低于对照组,差异有显著统计学意义(P0.01)。见表1。表1病例组与对照组子宫及卵巢RI、PI比较Tab.1Comparison of RI and PI of uterus and ovary between cas
21、e group and control group子宫卵巢项目例数RIPIRIPI对照组1000.81 0.122.14 0.210.62 0.120.91 0.14病例组1200.89 0.142.87 0.260.43 0.070.73 0.11t一4.50023.03713.97310.447P0.0000.0000.0000.000一2.2两组血清炎性因子水平比较病例组血清TNF-、IL-6、E S 均显著高于对照组(20.95 3.05)ng/mL vs(12.52 2.51)ng/mL(12.54 1.57)pg/mL vs(6.33 1.05)pg/mL、(2 34.2 5 16
22、.33)g/L vs(156.97 17.05)g/L。t =2 2.0 9 7、33.755、44.0 16 1,差异有统计学意义(P0.05)2.3两组性激素水平对比病例组 LH、T 水平均显著高于对照组,FSH水平显著低于对照组,差异有显著统计学意义(P0.05)。见表2。表2 病例组与对照组LH、F S H、E 2、T 水平比较Tab.2Comparison of LH,FSH,E2,T levels between case group and control group项目例数E2/pg/mLLH/U/LT/ng/mLFSH/U/L对照组10047.96 5.334.59 1.02
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- 卵巢 综合征 患者 多普勒 超声 测量 参数 性激素 因子 水平 相关性 分析