| Objective: To investigate blood flow parameters of the ovarian stromal artery, uterine artery and arteria helieinae of circum-endometrium in women with PCOS and to study the relationship between these parameters with the major hormonal and clinical-metabolic features of PCOS.Methods: A prospective study was carried out in 101 patients with PCOS and 25 age-matched controls. Clinical, metabolic and hormonal characteristics were measured at the early follicular phase. All PCOS patients do oral glucose tolerance test(OGTT) and insulin releasing test(IRT). Utero-ovarian Doppler ultrasound blood flow parameters were determined at the same time--pulsatility index(PI) and resistent index(RI). Data analysis was performed by t test and Pearson coefficient of correlation.Results:1. PI (2.90±0.72, 2.92±0.71 versus 2.48±0.63, 2.59±0.81) and RI (0.88±0.06, 0.88±0.06 versus 0.85±0.06, 0.85±0.06) in both right and left uterine artery were quite elevated (P=0.0109, P=0.0423, P=0.0135, P=0.0295, respectively) in women with PCOS compared with that of the control group, while PI (0.81±0.13, 0.81±0.11 versus 0.95±0.15, 1.01±0.16) and RI (0.53±0.05, 0.52±0.05 versus 0.58±0.06, 0.59±0.05) in both right and left ovarian stromal artery were significantly depressed (P<.0001, all of them) in women with PCOS compared with that of the control group.2. WHR, the serum levels of LH, T and LH/FSH ratio (0.89±0.06, 12.52±6.85, 1.71±0.72, 2.06±1.19 versus 0.85±0.03, 6.15±1.81, 1.19±0.64, 0.89±0.35) were quite elevated (P=0.0042,P<.0001, P<.0001, P=0.0039, respectively) in the patients compared with the control group.3. The serum levels of PRL (272.1±83.39 versus 338.5±137.0) was significantly higher (P<0.05) in patients with insulin resistance (IR) than those without IR; BMI (26.73±3.20 versus 22.51±3.04) and WHR (0.93±0.04 versus 0.86±0.06) in IR group of the patients were notablely bigger (P<.0001, both) than in the non-IR group; In addition, doppler indices, PI (3.12±0.69 versus 2.75±0.55) of the right uterine artery, RI (0.54±0.05 versus 0.51±0.054) of the left ovarian stromal artery were quite elevated (P=0.0294, P=0.0463, respectively).4. The serum levels of LH (14.52±6.21 versus 10.98±6.97), LH/FSH ratio (2.47±1.27 versus 1.76±1.04) in amenorrhea group of PCOS women were higher (P=0.0092, P=0.0026, respectively) than in menstrual period group.5. The serum level of LH and LH/FSH ratio were negatively correlated with BMI (r=-0.237,P<0.05;r=-0.303,P<0.01) and WHR (r=-0.271,P<0.05;r=-0.349,P<0.01) in women with PCOS; Doppler indices, PI and RI of the right uterine artery of PCOS women were negatively correlated with PRL (r=-0.215,P<0.05;r=-0.218,P<0.05), at the same time, PI and RI of the right ovarian stromal artery were negatively correlated with LH(r=-0.233,P<0.05;r=-0.207 , P<0.05), and quite negatively correlated with LH/FSH ratio (r=-0.269,P<0.01;r=-0.270,P<0.01).6. Doppler indices, PI and RI of the right uterine artery in the amenorrhea group were negatively correlated with PRL (r=-0.333,P<0.05;r=0.334,P<0.05). PI of the arteria helieinae of circum-endometrium in amenorrhea group of women with PCOS was positively correlated with T (r=0.393,P<0.01), while RI of the arteria helieinae of circum-endometrium in amenorrhea group of women with PCOS was positively correlated with LH/FSH ratio (r=0.343,P<0.05).Conclusion:1. Color Doppler ultrasonography can not only directly image the morphous of organs in the pelvic cavity, but also observate doppler blood flow changes within the organs of the pelvic cavity and measure their parameters.2. Vascularization of the ovarian stroma was more abundant in patients with PCOS than in the control group. Ovarian stromal blood flow was higher and uterine perfusion was lower in women with PCOS compared with women who did not have PCOS.3. The associativity between PRL and haemodynamics changes(PI,RI) of utero-ovarian arteries need to investigate further. PI,RI of ovarian stroma artery are negatively associated with LH,LH/FSH ratio. the distinction of hemodynamics parameters between left and right arteries need to be studied further.4. The relationship between IR and haemodynamics changes of arteria utero-ovarica need to investigate further.5. PI and RI of the arteria helieinae of circum-endometrium are positively correlated with T and LH/FSH ratio.In a word, the application of Color Doppler ultrasound may provide favourable applied information about the etiopathogenesis and therapeutic efficacy of PCOS.
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