宫腔灌注粒细胞集落刺激因子在薄型子宫内膜患者中的应用研究

发布时间：2018-03-18 02:13

  本文选题：粒细胞集落刺激因子　切入点：子宫内膜厚度、形态　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：观察并分析宫腔内灌注粒细胞集落刺激因子(granulocyte colony-stimulating factor, G-CSF)对薄型子宫内膜患者的子宫内膜厚度、形态及子宫血流的影响,探讨其对薄型子宫内膜患者的应用效果。方法：选取在广西医科大学第一附属医院生殖医学研究中心己接受IVF-ET助孕未能成功,拟行FET助孕但使用人工周期准备内膜2个或2个周期以上反复B超检测子宫内膜厚度均小于7mm的薄型子宫内膜患者30例,于再次行人工周期准备内膜的周期第13天(D13)、第16天(D16)分别加用宫腔内灌注rhG-CSF150ug,共2次,分别于周期第13天(D13)、16天(D16)、19天(D19)的当天行灌注前B超检测子宫内膜厚度、形态、子宫血流情况,血清E2水平及血常规,比较：1.灌药周期与灌药前一周期D13、D16、D19子宫内膜厚度,灌药周期的D13与D16、D19子宫内膜厚度；2.灌药周期与灌药前一周期D13、D19的血清E2水平,灌药周期的D13与D19血清E2水平；3.灌药周期的D13与D16、D19的子宫内膜形态(A型、B型、C型)；4.灌药周期的D13与D16、D19子宫内膜下血流(Ⅰ型、Ⅱ型、Ⅲ型)；5.灌药周期的D13与D16、D19子宫动脉及子宫内膜血流指数(RI、PI、S/D);6.灌药前(D13)与灌药后(D19)的血常规指标。结果：1.子宫内膜厚度比较：灌药周期与灌药前一周期的D13、D16、D19分别比较,D13、D16差异均无统计学意义(p0.05)；D19差异有统计学意义(p0.05)。灌药周期的D13分别与D16、D19比较,D16差异无统计学意义(p0.05)；D19差异有统计学意义(p0.05)。2.血清E2水平比较：灌药周期与灌药前一周期的D13、D19分别比较,D13、D19差异均无统计学意义(p0.05)。灌药周期的D13与D19组比较,差异有统计学意义(p0.05)。3.子宫内膜形态A型、B型、C型指标的比较：灌药周期的D13与D16、D19分别比较,D16及D19的A型、B型、C型差异均无统计学意义(p0.05)。4.子宫内膜下血流分型Ⅰ型、Ⅱ型、Ⅲ型指标的比较：灌药周期的D13与D16、D19分别比较,D16Ⅰ型、Ⅱ型、Ⅲ型差异均无统计学意义(p0.05)；D19Ⅰ型、Ⅱ型、Ⅲ型差异均有统计学意义(p0.05)。5.子宫动脉及子宫内膜血流RI、PI、S/D指标比较：灌药周期的D13子宫动脉血流指数RI、PI、S/D与D16、D19的分别比较,差异均无统计学意义(p0.05)；灌药周期的D13子宫内膜血流指数RI、PI、S/D与D16、D19的分别比较,D16的RI、PI、S/D差异均无统计学意义(p0.05)；D19的RI、PI、S/D差异均有统计学意义(p0.05)。6.灌药前(D13)与灌药后(D19)的血常规指标比较：D13与D19的外周血白细胞、中性粒细胞百分比、血小板计数相比,白细胞、中性粒细胞百分比、血小板比较差异均无统计学意义(p0.05)。结论：1.薄型子宫内膜患者人工周期准备内膜时加用宫腔灌注rhG-CSF,可以改善其子宫内膜厚度,可能增加子宫内膜的血流2.宫腔灌注G-CSF手术简单、方便,安全
[Abstract]:Objective: to observe and analyze the effect of granulocyte colony-stimulating factor (G-CSF) on endometrial thickness, morphology and uterine blood flow in patients with thin endometrium. Methods: IVF-ET was used in the center of reproductive medicine of the first affiliated hospital of Guangxi Medical University. Thirty patients with thin endometrium whose thickness of endometrium were less than 7 mm were detected by B-mode ultrasound with FET assisted pregnancy but using artificial cycle to prepare endometrium for 2 or more cycles. On the 13th day of artificial cycle preparation of endometrium, on the 13th day, on the 16th day, the endometrium was infused with rhG-CSF150ug2, respectively. On the 13th day of the cycle, the thickness and morphology of endometrium were measured by B-mode ultrasound on the 13th day of the cycle, and on the 13th day of the cycle, the endometrium thickness and morphology were measured by B-mode ultrasound. Uterine blood flow, serum E _ 2 level and blood routine were compared. The endometrial thickness of D13D _ (16) D _ (19) and D13 and D _ (16) D _ (19) of the perfusion cycle were compared with that of the previous cycle. The serum E _ (2) level of the drug administration cycle was higher than that of D13 (D _ (13)) D _ (19). Serum E _ 2 levels of D13 and D19 in the perfusion cycle were 3.The endometrial morphology of D13 and D16 / D19 were as follows: type A and B, type C, and subendometrial blood flow (type 鈪，

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