摘要
目的探究宫腔镜下黏膜下肌瘤术后宫腔粘连与粘连相关因子的关联性。方法女性宫腔镜下黏膜下肌瘤术后宫腔粘连的患者160例作为病例组,按疾病、术式、年龄、体重作为匹配因素选取同时期未发生术后宫腔粘连的患者160例作为对照组。将血清粘连相关因子[转化生长因子β1(TGF-β1)、血小板源性生长因子BB(POGF-BB)、基质金属蛋白酶组织抑制因子1(TIMP-1)]和炎性因子[白介素-6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)、超敏C-反应蛋白(CRP)、降钙素原(RCT)]作为协变量分别进行Logistic回归分析;筛选协变量进行多因素综合logistic回归分析。结果血清TNF-α(OR=1.40,95%CI=1.21~1.59)、TGF-β1(OR=1.77,95%CI=1.47~1.98)、PDGF-BB(OR=1.27,95%CI=1.05-1.58)和TIMP-1(OR=1.15,95%CI=1.08~1.36)的表达量是宫腔镜粘膜下肌瘤术后宫腔黏连发生的独立危险因素。受试者工作曲线ROC曲线下面积0.79,差异有统计学意义(P<0.05)。结论宫腔镜下黏膜下肌瘤术后宫腔粘连可能与TNF-α、TGF-β1,PDGF-BB、TIMP-1表达相关,术前术后应着重检查上述指标,以增强疾病预判能力。
Objective To investigate the correlation between intrauterine adhesions and adhesion factors in patients with submucosal myoma after hysteroscopic submucosal myoma operation.Methods A total of 160 patients with intrauterine adhesions who underwent hysteroscopic submucosal myoma operation in our hospital were enrolled as case group,and the other 160 patients without intrauterine adhesions who underwent hysteroscopic submucosal myoma operation were enrolled as control group.Logistic regression analysis was used to analyze the serum adhesion-related proteins and inflammatory factors including TGF-β1,POGF-BB,TIMP-1,IL-6,IL-8,TNF-α,CRP,RCT.Results The multivariate Logistic regression analysis showed that serum TNF-α(OR=1.40,95%CI=1.21~1.59),TGF-β1(OR=1.77,95%CI=1.47~1.98),and the expression levels of PDGF-BB(OR=1.27,95%CI=1.05~1.58)as well as TIMP-1(OR=1.15,95%CI=1.08~1.36)were the risk factors influencing the incidence of intrauterine adhesions after hysteroscopic submucosal myoma operation.The area under the ROC curve of the receiver’s working curve was 0.79,and the difference was statistically significant(P<0.05).Conclusion The incidence of intrauterine adhesions after hysteroscopic submucosal myoma operation may be corrrelated with the expression levels of TNF-α,TGF-β1,PDGF-BB and TIMP-1,therefor,it is necessary to pay mecu attention to the detection of above indexes so as to improve the ability of disease prediction.
作者
薛彩星
李玉萍
靳利利
XUE Caixing;LI Yuping;JIN Lili(Department of Gynecology,Zhangjiakou Hospital for Maternal and Child Health,Hebei, Zhangjiakou 075000, China)
出处
《河北医药》
CAS
2020年第5期730-732,736,共4页
Hebei Medical Journal
关键词
黏膜下肌瘤
宫腔粘连
粘连相关因子
炎症因子
LOGISTIC回归
submucosal fibroids
intrauterine adhesions
adhesion-related factors
inflammatory factors
Logistic regression
