国家卫生健康委科学技术研究所
国家重点研发专项(022YFF0711001);中央级公益性科研院所基本科研业务专项资金面上项目((No.2023GJM04).
National Research Institute for Family Planning
目的 分析彩色多普勒超声参数与多囊卵巢综合征(PCOS)合并高胰岛素血症(HI)大鼠胰岛素敏感性指数(ISI)的评估价值。方法 选取140 只龄 3 周龄SPF级 SD 雌性大鼠为研究对象,制备 PCOS 未合并 HI 大鼠模型(对照组 70 只)和PCOS合并HI大鼠模型(研究组 70 只),造模成功后,应用彩色多普勒超声检测大鼠卵巢的物理指标、血液动力学指标和超声表现特征,并抽取静脉血以评估ISI。而后给予研究组大鼠二甲双胍灌胃治疗,比较有效组、无效组彩色多普勒超声参数,绘制受试者工作曲线(ROC),分析彩色多普勒超声参数对PCOS合并HI大鼠的疗效评估价值。结果 研究组卵巢总面积(TA)、卵巢体积(OV)、卵巢间质面积(SA)、血管化指数(VI)、血流指数(FI)、空腹胰岛素(FINS)、空腹血糖(FPG)均大于对照组,阻力指数(RI)、搏动指数(PI)、ISI均小于对照组,差异有统计学意义(P＜0.05)。研究组中TA、SA与ISI呈负相关(r= -0.501、-0.492,P＜0.05),RI、PI与ISI呈正相关(r= 0.504、0.485,P ＜ 0.05)。疗效良好组TA、OV、SA、VI、FI、VFI、PSV、PDV、低密度脂蛋白胆固醇、FPG、FINS、LH、FSH均小于疗效不佳组,RI、PI均大于疗效不佳组,差异有统计学意义(P＜0.05)。ROC曲线分析显示,彩色多普勒超声参数联合评估临床疗效的灵敏度、特异度分别为90.9%、90.2%,曲线下面积(AUC)为0.901。结论 彩色多普勒超声参数与PCOS合并HI大鼠的ISI及临床疗效具有密切关系。
Objective To analyze the relationship between color doppler ultrasound parameters and insulin sensitivity index (ISI) and clinical efficacy in rats with polycystic ovary syndrome (PCOS) combined with hyperinsulinemia (HI). Methods 140 3-week-old female SD rats of SPF grade were selected and randomly divided into two groups. The PCOS combined with hi rat model (Study Group) and PCOS without hi rat model (control group) was prepared respectively. After successful modeling, the rats were examined by color doppler ultrasound, and the total area (TA), ovarian volume (OV), interstitial area (SA), vascularization index (VI), blood flow index (FI), vascularized blood flow index (VFI), peak systolic blood flow velocity (PSV), peak diastolic blood flow velocity (PDV), resistance index (RI), and ovarian interstitial artery pulsation index (PI) were compared between the two groups. Fasting insulin (fins) and fasting blood glucose (FPG) were measured in rats" fasting venous blood at the same time, and ISI was calculated. Pearson correlation analysis was used to analyze the correlation between color doppler ultrasound parameters and ISI in the study group. The rats in the study group were treated with metformin by intragastric administration. According to the therapeutic effect, the rats in the study group were divided into the good effect group and the poor effect group. The color doppler ultrasound parameters of the two groups were compared, and the receiver operating characteristic curve (ROC) was drawn to analyze the value of color doppler ultrasound parameters in evaluating the curative effect of PCOS combined with hi rats. Results: 65 rats with PCOS and hi were successfully established in the study group, and 60 rats without PCOS and hi were successfully established in the control group. The body weight, body mass index, systolic blood pressure, diastolic blood pressure, Ta, OV, SA, VI, fi, VFI, PSV, PDV, fins and FPG of the study group were higher than those of the control group, while RI, PI and ISI of the study group were lower than those of the control group, and the differences were statistically significant (P<0.05). Pearson correlation analysis showed that color doppler ultrasound parameters TA and SA were negatively correlated with ISI (r=-0.501, -0.492, P<0.05), and ovarian RI and PI were positively correlated with ISI (r=0.504, 0.485, P<0.05). In the group with good curative effect, Ta、OV、SA、VI、FI、VFI、PSV、PDV、 Low density lipoprotein cholesterol, FPG, fins, LH, FSH were lower than those in the poor efficacy group, RI, PI were higher than those in the poor efficacy group, the difference was statistically significant (P<0.05). ROC curve analysis showed that the sensitivity and specificity of color doppler ultrasound parameters combined with clinical efficacy were 90.9% and 90.2%, respectively, and the area under the curve (AUC) was 0.901. Conclusion Color doppler ultrasound parameters are closely related to ISI and clinical efficacy of PCOS combined with hi rats, which can predict the clinical efficacy of such patients to a certain extent.
