Abdel-Gadir Ahmed, Oyawoye Oluseye O, Chander Bina P
London Female and Male Fertility Centre, Highgate Hospital, London, UK.
J Reprod Med. 2009 Jun;54(6):347-52.
To examine the coexistence of fibroids and ultrasonically diagnosed polycystic ovaries (PCO) and their combined effects on the uterine artery blood flow in relation to age and parity in women with regular menstruation.
One thousand seventy women, 18-40 years old, with gynecologic or infertility problems, were investigated with transvaginal ultrasound for uterine fibroids and PCO. A subgroup of 468 patients with regular cycles had repeated examinations up to ovulation time. Midcycle mean uterine artery pulsatility index (PI) and Doppler pulse waveform patterns were examined in relation to age, parity, PCO and fibroids. Cross tabulation with chi2 and ANOVA were used for data analysis. A two-tailed p value < 0.05 was taken as significant.
One hundred eleven of 343 patients > 35 years old (32.4%) had PCO compared to 479/727 younger women (65.9%) (p < 0.001). Furthermore, fewer patients with PCO (67 of 590, 11.4%) had fibroids as compared to patients with normal ovaries (131 of 480, 27.3%) (p < 0.001). This negative correlation was maintained irrespective of age, parity or ethnic origin. PCO were associated with higher uterine artery PI and more unfavourable Doppler pulse waveform patterns in women < 35 years old and nulliparous women. This effect was not maintained in parous women and those > or = 35 years old. Fibroids did not alter the effect of PCO but increased the uterine artery blood flow in patients with normal-looking ovaries.
The effect of PCO on the uterine artery blood flow is modulated by age and parity but not by fibroids, which are less common in women with PCO.
研究肌瘤与经超声诊断的多囊卵巢（PCO）的共存情况，以及它们对月经规律的女性子宫动脉血流的综合影响，并探讨其与年龄和生育状况的关系。
对1070名年龄在18至40岁之间、患有妇科疾病或不孕症的女性进行经阴道超声检查，以检测子宫肌瘤和PCO。468名月经周期规律的患者组成一个亚组，在排卵前进行多次检查。在月经周期中期，检测平均子宫动脉搏动指数（PI）和多普勒脉冲波形，并分析其与年龄、生育状况、PCO和肌瘤的关系。采用卡方检验和方差分析进行数据分析，双侧p值<0.05被认为具有统计学意义。
343名年龄>35岁的患者中，111名（32.4%）患有PCO，而727名年轻女性中有479名（65.9%）患有PCO（p<0.001）。此外，与卵巢正常的患者相比，患有PCO的患者中肌瘤患者较少（590名中有67名，11.4%），而卵巢正常的患者中有131名（480名中的27.3%）患有肌瘤（p<0.001）。无论年龄、生育状况或种族如何，这种负相关关系均成立。在<35岁的女性和未生育的女性中，PCO与较高的子宫动脉PI和更不利的多普勒脉冲波形相关。在已生育的女性和年龄≥35岁的女性中，这种影响并不存在。肌瘤不会改变PCO的影响，但会增加卵巢外观正常的患者的子宫动脉血流。
PCO对子宫动脉血流的影响受年龄和生育状况的调节，而不受肌瘤的影响，肌瘤在患有PCO的女性中较少见。
