| 陈丽荣,黄静,张步林,程立雪,李丽鹏,肖维维,黄彦妮.经阴道三维超声检测子宫内膜-肌层结合带对IVF-ET妊娠结局的预测价值[J].声学技术,2020,39(3):311~315 |
| 经阴道三维超声检测子宫内膜-肌层结合带对IVF-ET妊娠结局的预测价值 |
| The predictive value of uterine junctional zone detected by transvaginal three-dimensional ultrasound in IVF-ET pregnancy outcome |
| 投稿时间：2020-03-01 修订日期：2020-04-20 |
| DOI：10.16300/j.cnki.1000-3630.2020.03.010 |
| 中文关键词: 经阴道超声 子宫内膜容受性 子宫内膜结合带 体外受精 不孕 |
| 英文关键词: transvaginal ultrasound endometrial receptivity uterine junctional zone in vitro fertilization infertility |
| 基金项目:广西壮族自治区卫生健康委员会自筹课题（Z20180292）。 |
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| 中文摘要: |
| 目的：探讨经阴道三维超声（Transvaginal Three-Dimensional Ultrasound，3D-TVUS）检测子宫内膜-肌层结合带（Junctional Zone，JZ）对体外受精与胚胎移植（In Vitro Fertilization and Embryo Transfer，IVF-ET）妊娠率的影响。方法：应用3D-TVUS对128例接受IVF-ET的不孕患者于人绒毛膜促性腺激素（HCG）注射日进行JZ测定，在3D-TVUS获得的子宫冠状切面上评估JZ形态和厚度，测量JZ最大厚度（dJZmax）、JZ最小厚度（dJZmin）及JZ最大厚度与最小厚度的差值（ΔdJZmax-min）。根据妊娠结果分为妊娠组与非妊娠组，比较两组间各参数的差异。结果：128例患者临床妊娠58例，妊娠率56.25%。与妊娠组相比，非妊娠组dJZmax及ΔdJZmax-min显著增加（P<0.01），dJZmax截止值为6.75 mm时，诊断敏感度94.4%，特异度62.5%，阳性预测值72%，阴性预测值92%，准确性94%；ΔdJZmax-min截止值为3.75 mm时，诊断敏感度91.7%，特异度69.6%，阳性预测值75%，阴性预测值89%，准确性92%。JZ形态异常IVF-ET妊娠失败的可能性是正常的5.42倍（比值比RO=5.42，95%可信区间为2.45~11.97）。结论：JZ可作为IVF-ET妊娠结局的常规预测指标，JZ异常可能会导致IVF-ET妊娠失败。 |
| 英文摘要: |
| Objective:To investigate the effect of uterine junctional zone (JZ) detected by transvaginal three-dimensional ultrasound (3D-TVUS) on the pregnancy rate of in vitro fertilization and embryo transfer (IVF-ET). Method:The JZ of 128 infertile patients receiving IVF-ET were measured by 3D-TVUS on the day of hCG injection. The data of JZs relating to the shape and thickness including the maximum thickness (dJZmax), the minimum thickness (dJZmin) and their difference (ΔdJZmax-min) on the coronal section of uterus obtained by 3D-TVUS were evaluated respectively and then the differentiations were compared between pregnancy and non-pregancy groups. Results:The clinical pregnancy rate was 56.25% in 128 cases. Compared with pregnancy group, dJZmax and ΔdJZmax-min in non-pregnancy group increased significantly (P<0.01). When the cut-off value of dJZmax was 6.75 mm, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 94.4%, 62.5%, 72%, 92%, and 94%, respectively. And when the cut-off value of ΔdJZmax-min was 3.75 mm, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 91.7%, 69.6%, 75%, 89%, and 92%, respectively. The failure rate of IVF-ET with JZ morphological abnormality was 5.42 times higher than that of the normal (RO=5.42, and the 95% confidence interval is 2.45-11.97). Conclusion:JZ can be used as a routine predictor of IVF-ET outcome, and JZ abnormality may lead to IVF-ET failure. |
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