| 摘要: |
| 目的 探讨经阴道三维超声能量多普勒血流参数对子宫腺肌病不孕患者体外受精-胚胎移植 (IVF-ET)妊娠结局的预测价值。方法 回顾性分析2022年1月-2022年12月于邯郸市中心医院接受IVF-ET的100例子宫腺肌病不孕患者的作为研究组,同期纳入40例单纯不孕患者作为对照组,所有患者均于IVF-ET前接受经阴道三维超声能量多普勒检查,比较两组经阴道三维超声能量多普勒血流参数。所有患者均随访孕期至分娩,记录两组患者的妊娠结局,比较妊娠组和未妊娠组患者的经阴道三维超声能量多普勒血流参数,采用二元Logistic回归分析筛选出影响患者妊娠结局的独立危险因素,采用受试者工作特征(ROC)曲线评估经阴道三维超声能量多普勒血流参数对患者IVF-ET妊娠结局的预测效能。结果 研究组和对照组患者的子宫内膜-肌层交界区(EMI)平均厚度、容积、血管指数(VI)和血管化血流指数(VFI)比较,差异无统计学意义(P＞0.05)。研究组患者的血流指数(FI)较对照组低,形态异常比例高于对照组,差异有统计学意义(P＜0.05)。100例子宫腺肌病不孕患者接受IVF-ET后成功妊娠60例,未成功妊娠40例。妊娠组患者EMI形态、平均厚度、容积、VI、FI、VFI均高于未妊娠组,差异有统计学意义(P＜0.05)。EMI 容积和EMI-VFI指标均为影响子宫腺肌病不孕患者IVF-ET妊娠结局的独立危险因素(P＜0.05)。EMI容积和EMI-VFI指标预测子宫腺肌病不孕患者IVF-ET妊娠结局的ROC曲线下面积为0.795和0.672,此时患者EMI容积和EMI-VFI截断值为3.085 cm3和0.597,以经阴道三维超声能量多普勒血流参数中的EMI容积和EMI-VFI指标预测子宫腺肌病不孕患者IVF-ET妊娠结局具有较好效能。结论 经阴道三维超声能量多普勒血流参数对子宫腺肌病不孕患者IVF-ET妊娠结局具有较高预测价值。 |
| 关键词: 经阴道三维超声能量多普勒超声 子宫腺肌病 不孕 体外受精-胚胎移植 妊娠结局 |
| DOI： |
| 投稿时间：2024-03-11修订日期：2024-03-11 |
| 基金项目:课题： 河北省2021年度医学科学研究课题计划 批号：20211501 |
|
| Predictive value of transvaginal three-dimensional ultrasound energy Doppler blood flow parameters for IVF-ET pregnancy outcomes in patients with infertility and adenomyosis |
| wangfuming,shenxianghui,河北省邯郸市中心医院,zhanghuan,yinsufang |
| () |
| Abstract: |
| Objective To explore the predictive value of transvaginal three-dimensional ultrasound energy Doppler blood flow parameters for pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) in patients with infertility and adenomyosis. Methods A retrospective analysis was performed on 100 patients with infertility and adenomyosis (study group) and 40 patients with simple infertility (control group) who underwent IVF-ET in Handan First People"s Hospital between January and December 2022. All patients underwent examination of transvaginal three-dimensional ultrasound energy Doppler before IVF-ET, and blood flow parameters of transvaginal three-dimensional ultrasound energy Doppler were compared between the two groups. All patients were followed up from pregnancy to delivery to record pregnancy outcomes. The blood flow parameters of transvaginal three-dimensional ultrasound energy Doppler were compared between pregnancy group and non-pregnancy group. The independent risk factors affecting pregnancy outcomes in patients. The predictive efficiency of transvaginal three-dimensional ultrasound energy Doppler blood flow parameters for pregnancy outcomes of IVF-ET was evaluated by receiver operating characteristic (ROC) curves. Results There was no significant difference in mean thickness, volume, vascularization index (VI) and vascularization flow index (VFI) of endometrial-myometrial interface (EMI) between study group and control group (P>0.05). The flow index (FI) in study group was lower than that in control group, and proportion of morphological abnormality was higher than that in control group (P<0.05). In the 100 patients with infertility and adenomyosis, there were 60 cases with successful pregnancy and 40 cases with unsuccessful pregnancy after IVF-ET. EMI morphology, mean thickness, volume, VI, FI and VFI in pregnancy group were higher than those in non-pregnancy group (P<0.05). EMI volume and EMI-VFI were independent risk factors of IVF-ET pregnancy outcomes in patients with infertility and adenomyosis (P<0.05). The area under ROC curve (AUC) and cut-off values of EMI volume and EMI-VFI for predicting pregnancy outcomes of IVF-ET in patients with infertility and adenomyosis were (0.795, 0.672) and (3.085cm3, 0.597), showing good predictive efficiency. Conclusion Transvaginal three-dimensional ultrasound energy Doppler blood flow parameters have high predictive value for IVF-ET pregnancy outcomes in patients with infertility and adenomyosis. |
| Key words: Transvaginal three-dimensional ultrasound energy Doppler Adenomyosis Infertility In vitro fertilization-embryo transfer Pregnancy outcome |
