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目的:比较多囊卵巢综合征(polycystic ovary syndrome,PCOS)伴与不伴高雄激素血症的患者超声特征及内分泌指标差异,并分析其间的相关性。方法:以睾酮≥1.08 ng/mL或游离睾酮≥3.18 pg/mL为标准,将126例PCOS患者分为PCOS伴高雄激素血症(hyperandrogenism,HA)(PCOS/HA组,34例)与PCOS不伴高雄激素(PCOS/NHA组,92例)。采用腔内超声检查测量并比较2组患者卵巢、子宫的灰阶及彩色多普勒二维超声参数;同时检测并比较2组患者的内分泌代谢指标,分析各超声参数与各内分泌代谢指标间的相关性。结果:PCOS/HA组患者的年龄明显小于PCOS/NHA组(P<0.05),而其卵巢体积、卵巢卵泡数、卵巢间质面积、卵巢间质面积与总面积之比、子宫动脉阻力指数均较PCOS/NHA组明显增高(P均<0.05),其卵巢间质动脉阻力指数则较PCOS/NHA组显著降低(P<0.01)。内分泌指标中,PCOS/HA组患者的睾酮、游离睾酮、硫酸脱氢表雄酮、雄烯二酮、三酰甘油、空腹血浆胰岛素均显著高于PCOS/NHA组(P均<0.05)。且PCOS/HA患者的卵巢卵泡数与其游离睾酮、糖化血红蛋白水平呈正相关(r分别为0.62、0.78,P均<0.01);其卵巢体积、子宫动脉阻力指数与其体质量指数呈正相关(r分别为0.64、0.57,P分别<0.01、<0.05);其卵巢间质动脉阻力指数则与体质量指数、性激素结合球蛋白、胰岛素抵抗指数、空腹血浆胰岛素水平相关(r分别为-0.46、0.55、-0.55、-0.57,P均<0.05)。结论:PCOS/HA组与PCOS/NHA组患者间的超声特征及内分泌指标有一定差异,且PCOS/HA组中这两者间有一定相关性。
Objective: To compare the differences of ultrasound features and endocrine indexes between patients with polycystic ovary syndrome (PCOS) and those without hyperandrogenism and to analyze the correlation between them. Methods: 126 patients with PCOS were divided into PCOS with hyperandrogenism (HA) (PCOS / HA group, 34 cases) and PCOS without testosterone ≥1.08 ng / mL or free testosterone ≥3.18 pg / mL With androgen (PCOS / NHA group, 92 cases). The intracavitary ultrasonography was used to measure and compare the two groups of ovarian and uterine grayscale and color doppler two-dimensional ultrasound parameters. At the same time, the endocrine and metabolic indexes of the two groups were detected and compared, and the correlations between the ultrasonic parameters and the endocrine and metabolic indexes Correlation. Results: The age of PCOS / HA group was significantly lower than that of PCOS / NHA group (P <0.05), but the ovarian volume, ovarian follicle count, ovarian interstitial area, ratio of ovarian stromal area to total area and uterine artery resistance index Compared with PCOS / NHA group, the resistance index of ovarian stromal artery in PCOS / NHA group was significantly lower than that in PCOS / NHA group (all P <0.05). In the endocrine index, testosterone, free testosterone, dehydroepiandrosterone, androstenedione, triglyceride and fasting plasma insulin in PCOS / HA group were significantly higher than those in PCOS / NHA group (all P <0.05). The number of ovarian follicles in PCOS / HA patients was positively correlated with free testosterone and glycosylated hemoglobin (r = 0.62,0.78, P <0.01). The ovarian volume and uterine artery resistance index were positively correlated with their body mass index 0.64,0.57, P <0.01, <0.05 respectively). The resistance index of ovarian interstitial artery correlated with body mass index, sex hormone binding globulin, insulin resistance index and fasting plasma insulin level (r = -0.46,0.55, 0.55, -0.57, P <0.05). Conclusion: There are some differences between the PCOS / HA group and the PCOS / NHA group in sonographic features and endocrine parameters, and the PCOS / HA group have some correlations.