Zaidi J, Collins W, Campbell S, Pittrof R, Tan S L
Department of Obstetrics and Gynaecology, King's College School of Medicine and Dentistry, London, UK.
Ultrasound Obstet Gynecol. 1996 Feb;7(2):135-40. doi: 10.1046/j.1469-0705.1996.07020135.x.
Intraovarian blood flow was assessed by transvaginal color and pulsed Doppler ultrasound prospectively in six women during the periovulatory period. All patients had regular ovulatory menstrual cycles and a mid-luteal serum progesterone level consistent with spontaneous ovulation in the preceding cycle. Each patient underwent serial transvaginal ultrasound examination and Doppler assessment of blood flow in the ovarian stroma and in the wall of the dominant follicle or corpus luteum. When the mean follicular diameter was > 16 mm or day -2 from the estimated day of ovulation was reached, patients were scanned at 6-h intervals at 06.00, 12.00, 18.00 and 24.00 until follicular rupture, to investigate the presence of circadian rhythms. The pulsatility index (PI) and the maximum peak systolic blood flow velocity (Vmax) were calculated as Doppler indices of impedance to blood flow and velocity, respectively. A venous blood sample was taken at each visit for subsequent hormonal analysis. There was no significant circadian fluctuation in either mean follicular Vmax or mean follicular PI before or after the luteinizing hormone (LH) surge. Similarly, mean Vmax and mean PI in the non-dominant ovarian stroma did not show any significant fluctuation over the same periods. The mean PI in the dominant ovarian stroma showed daily fluctuations with the highest values occurring most commonly at 06.00 and the nadir in the afternoon and late evening. This fluctuation was the reverse of the circadian variation previously demonstrated in the uterine artery. However, in contrast to the uterine artery, comparison between the mean PI values in the dominant ovarian stroma at 06.00 and 18.00 only approached significance after the LH surge. The dominant ovarian stroma Vmax tended to rise during the day, although the differences between 06.00 and 18.00 were also not significant. Although there are fluctuations in Doppler blood flow indices in the dominant ovarian stroma, further studies are necessary to demonstrate whether this represents a significant circadian rhythm.
前瞻性地采用经阴道彩色及脉冲多普勒超声对6名处于排卵期的女性的卵巢内血流情况进行评估。所有患者月经周期规律，黄体中期血清孕酮水平与前一周期自发排卵情况相符。每位患者均接受了系列经阴道超声检查及卵巢基质和优势卵泡或黄体壁血流的多普勒评估。当卵泡平均直径>16 mm或距预计排卵日还有-2天时，从06:00、12:00、18:00和24:00开始每隔6小时对患者进行扫描，直至卵泡破裂，以研究昼夜节律的存在情况。分别计算搏动指数（PI）和最大收缩期血流峰值速度（Vmax）作为血流阻抗和速度的多普勒指标。每次就诊时采集静脉血样本用于后续激素分析。在促黄体生成素（LH）峰前后，优势卵泡的平均Vmax或平均PI均无显著的昼夜波动。同样，在同一时期，非优势卵巢基质中的平均Vmax和平均PI也未显示出任何显著波动。优势卵巢基质中的平均PI呈现出每日波动，最高值最常出现在06:00，下午和深夜为最低点。这种波动与先前在子宫动脉中显示的昼夜变化相反。然而，与子宫动脉不同的是，仅在LH峰后，优势卵巢基质在06:00和18:00时的平均PI值之间的比较才接近显著差异。优势卵巢基质的Vmax在白天有上升趋势，尽管06:00和18:00之间的差异也不显著。尽管优势卵巢基质中的多普勒血流指标存在波动，但仍需进一步研究以证实这是否代表显著的昼夜节律。
