Tsukanov Yurii Т, Nicolaichuk Aleksandr, Nicolaichuk Tatjana
Department of Surgery and Urology, Omsk State Medical University, Omsk, Russia -
Department of Surgery and Urology, Omsk State Medical University, Omsk, Russia.
Int Angiol. 2019 Apr;38(2):102-107. doi: 10.23736/S0392-9590.19.04084-7. Epub 2019 Feb 22.
The aim of this study was to investigate vein changes during the menstrual cycle in parous women with premenstrual leg heaviness.
А total of 39 women with heavy legs before menstruation were examined. Great saphenous vein (GSV) in the groin, femoral vein (FV) and popliteal vein (PV) were examined with ultrasound scanning before 10 a.m. and after 6 p.m. on days 1 to 4 (menstrual phase) and 25 to 28 (secretory phase). To characterize biophysical features of veins we used: 1) interphase gradient of the diameter (IGd), i.e. the difference in vein diameters during the secretory and menstrual phases; 2) orthostatic gradient of the diameter (OGd), i.e. the difference in vein diameters measured in the evening and in the morning.
Diameter changings for GSV, FV and PV were similar. GSV diameter increased from the morning during the menstrual phase to the evening during the secretory phase on average by 26.2%. OGd was 0.73 mm (95% CI: 0.59-0.87) during the menstrual phase and 0.62 mm (95% CI: 0.54-0.71) during the secretory phase. IGd was 0.73 mm (95% CI: 0.61-0.86) already in the morning. During the secretory phase 43.6% patients had the GSV reflux. During the whole menstrual cycle GSV diameter in the reflux zone increased on average by 40.6%. IGd of GSV in this zone reached 1.25 mm (95% CI: 1.02-1.48) in the morning and 1.30 mm (95% CI: 1.25-1.35) in the evening.
Women with premenstrual leg heaviness have a minimal vein diameter in the morning during the secretory phase. The maximal diameter is revealed in the evening during the secretory phase. Clinically manifested expansion of veins, including GSV refluxes, is found during the secretory phase due to increased expansibility of veins. However, because of increased creeping ability one observes expansion of veins during the whole menstrual cycle in these women.
本研究旨在调查有经前腿部沉重感的经产妇在月经周期中的静脉变化。
共检查了39名月经前腿部沉重的女性。在月经周期第1至4天（月经期）和第25至28天（分泌期）上午10点前和下午6点后，用超声扫描检查腹股沟大隐静脉（GSV）、股静脉（FV）和腘静脉（PV）。为了描述静脉的生物物理特征，我们使用了：1）直径的间期梯度（IGd），即分泌期和月经期静脉直径的差异；2）直径的直立梯度（OGd），即晚上和早上测量的静脉直径的差异。
GSV、FV和PV的直径变化相似。GSV直径从月经期上午到分泌期晚上平均增加26.2%。月经期OGd为0.73mm（95%CI：0.59 - 0.87），分泌期为0.62mm（95%CI：0.54 - 0.71）。IGd上午就已达0.73mm（95%CI：0.61 - 0.86）。分泌期43.6%的患者出现GSV反流。在整个月经周期中，反流区GSV直径平均增加40.6%。该区域GSV的IGd上午达到1.25mm（95%CI：1.02 - 1.48），晚上达到1.30mm（95%CI：1.25 - 1.35）。
有经前腿部沉重感的女性在分泌期早晨静脉直径最小。最大直径出现在分泌期晚上。由于静脉扩张性增加，在分泌期可发现临床上明显的静脉扩张，包括GSV反流。然而，由于蠕变能力增强，在这些女性的整个月经周期中都可观察到静脉扩张。
