目的 探讨子宫内膜异位症(EMS)不孕患者经阴道彩色多普勒超声子宫动脉血流参数、子宫内膜厚度、子宫内膜容受性(ER)的变化及意义。方法 选取2022-08至2025-08武警特色医学中心收治的EMS患者80例作为研究组,选择同期正常体检的健康育龄女性50例作为对照组,均行经阴道彩色多普勒超声检查,比较两组超声结果。结果 研究组月经周期第7、14、21天血流搏动指数(PI)、血流阻力指数(RI)高于对照组,收缩期峰值流速(PSV)、舒张末期流速(EDV)低于对照组,差异均有统计学意义(P<0.05)。两组月经周期第7、14、21天子宫内膜厚度逐渐增高,但研究组低于对照组,差异均有统计学意义(P<0.05)。研究组月经周期第7、14、21天的子宫内膜分型与对照组比较,研究组B型、C型比例均高,A型比例均低,差异有统计学意义(P<0.05),且研究组月经周期第7、14、21天的ER评分低于对照组,差异有统计学意义(P<0.05)。结论 EMS不孕患者较健康育龄女性子宫动脉血流参数PI、RI升高、PSV、EDV降低,子宫内膜容受性差,子宫内膜厚度降低,子宫内膜分型C型占比高,动态监测这些参数变化有助于EMS不孕患者的临床诊断。
Abstract
Objective To explore the changes and significance of uterine artery blood flow parameters, endometrial thickness and endometrial receptivity (ER) in infertile patients with endometriosis (EMS) by transvaginal color Doppler ultrasound. Methods A total of 80 EMS patients admitted to Characteristics Medical Center of Chinese People’s Armed Police Force from August 2022 to August 2025 were selected as the study group, and 50 healthy women of reproductive age who underwent normal physical examination during the same period were selected as the control group. All subjects underwent transvaginal color Doppler ultrasound examination, and the ultrasound results were compared between the two groups. Results The blood flow pulsatility index (PI) and blood flow resistance index (RI) of the endometrium on days 7, 14 and 21 of the menstrual cycle in the study group were higher than those in the control group, while the peak systolic velocity (PSV) and end-diastolic velocity (EDV) were lower than those in the control group. The differences were statistically significant (P<0.05).The endometrial thickness on the 7th, 14th and 21st days of the menstrual cycle in both groups gradually increased, but the study group was lower than the control group, and the differences were statistically significant (P<0.05) . The endometrial types of the study group on days 7, 14, and 21 of the menstrual cycle were compared with those of the control group, with a higher proportion of type B and C, and a lower proportion of type A (P<0.05), and the ER scores on the 7th, 14th and 21st days in the study group were lower than those in the control group (P<0.05). Conclusions Compared with healthy women of reproductive age, patients with EMS infertility have higher PI and RI of uterine artery blood flow, lower PSV and EDV, poor endometrial receptivity, decreased endometrial thickness, and a higher proportion of type C endometrium. Dynamic monitoring of these parameter changes is helpful for the clinical diagnosis of infertile EMS patients.
关键词
子宫内膜异位症 /
不孕症 /
子宫动脉血流参数 /
子宫内膜厚度 /
子宫内膜容受性
Key words
endometriosis /
infertility /
uterine artery blood flow parameters /
endometrial thickness /
endometrial receptivity
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