| 摘要: |
| 目的 探讨三维超声定量参数联合抗苗勒氏激素(AMH)检测对子宫切除术患者术后卵巢功能的评估价值。方法 选取2018年3月-2021年3月在本院行子宫切除术治疗的患者198例作为研究组,均行子宫切除术并保留双侧附件,于术前、术后1月、3月及12月均进行阴道三维超声,收集其相关定量参数[卵巢体积(OV)、卵巢间质动脉收缩期峰值流速(PSV)、卵巢间质动脉血管化指数(VI)]、性激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平]和AMH水平。分析各指标对子宫切除术患者术后卵巢功能的评估价值。并选取同期于我院进行妇科检查的健康妇女100例作为对照组。结果 研究组术前与对照组OV、PSV、VI值比较无差异(P>0.05)。研究组术后1月、6月及12月OV、PSV、VI值较术前比较均有下降(P<0.05),OV值随着术后时间的推移逐渐下降(P<0.05),术后12月的PSV、VI值均较术前1月及6月下降(P<0.05)。研究组术前FSH、LH、E2、AMH与对照组比较无差异(P>0.05)。研究组术后1月、6月及12月的FSH水平较术前升高,AMH均较术前下降(P<0.05)；研究组内FSH术后各时间点内水平比较无差异(P>0.05),AMH水平随着术后时间的推移逐渐下降(P<0.05)；术后12月E2值较术前、术后1月及术后6月下降(P<0.05)。198例患者术后随访1年,共有59例患者出现明显潮热、烦躁、失眠、焦虑、情绪失控等更年期综合征症状。其中有19例在术后6月开始出现,40例在术后12月开始出现。结论 三维超声可直观反映卵巢形态和卵巢血供情况,AMH水平具有较好的稳定性和敏感性,临床可联合两者进行子宫切除术后患者的卵巢功能的评价,以提高临床评估价值。 |
| 关键词: 三维超声定量参数 抗苗勒氏激素 子宫切除术 卵巢功能 |
| DOI： |
| 投稿时间：2022-08-22修订日期：2022-08-22 |
| 基金项目: |
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| Evaluation value of three-dimensional ultrasound quantitative parameters combined with anti-Müllerian hormone for ovarian function in patients after hysterectomy |
| wangguangyong,yangfeng,xeilan |
| () |
| Abstract: |
| Objective To explore the evaluation value of three-dimensional ultrasound quantitative parameters combined with anti-Müllerian hormone (AMH) for ovarian function in patients after hysterectomy. Methods A total of 198 patients undergoing hysterectomy with reservation of bilateral accessory in the hospital were enrolled as study group between March 2018 and March 2021. Before surgery, at 1 month, 3 months and 12 months after surgery, all underwent examination of vaginal three-dimensional ultrasound to collect related quantitative parameters [ovarian volume (OV), peak systolic velocity (PSV) and vascularization index (VI) of ovarian stroma], sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2)] and AMH. The evaluation value of the above indexes for ovarian function was analyzed. A total of 100 healthy women undergoing gynecological examinations during the same period were enrolled as control group. Results Before surgery, there was no significant difference in OV, PSV or VI between study group and control group (P>0.05). At 1 month, 6 months and 12 months after surgery, OV, PSV and VI in study group were decreased (P<0.05). As time went by, OV was gradually decreased (P<0.05). PSV and VI at 12 months after surgery were lower than those at 1 month and 6 months before surgery (P<0.05). Before surgery, there was no significant difference in FSH, LH, E2 or AMH between study group and control group (P>0.05). At 1 month, 6 months and 12 months after surgery, FSH was increased, while AMH was decreased in study group (P<0.05). There was no significant difference in FSH at different time points after surgery in study group (P>0.05). As time went by, AMH was gradually decreased (P<0.05). E2 at 12 months after surgery was lower than that before surgery, at 1 month and 6 months after surgery (P<0.05). In the 198 patients during the 1 year of follow-up, there were 59 cases with obvious menopausal syndromes (hot flashes, irritability, insomnia, anxiety, lost in emotions), including 19 cases with syndromes at 6 months after surgery and 40 cases at 12 months after surgery. Conclusion Three-dimensional ultrasound can directly reflect morphology and blood supply of ovary. AMH level has good stability and sensitivity. Clinically, three-dimensional ultrasound combined with AMH can evaluate ovarian function of patients after hysterectomy to improve clinical evaluation value. |
| Key words: Three-dimensional ultrasound quantitative parameter Anti-Müllerian hormone Hysterectomy Ovarian function |
