摘要
目的:探讨宫腔粘连患者宫腔粘连的危险因素。方法:回顾性收集2020年8月—2021年5月就诊于福建省妇幼保健院行宫腔镜手术的宫腔粘连患者(188例)和继发不孕患者(149例)的临床资料。比较两组年龄、体重指数(BMI)、孕次、产次、流产次数、末次妊娠情况及CD38和CD138表达的情况,并采用logistic分析影响宫腔粘连的因素。结果:宫腔粘连组的孕次、产次及流产次数均显著多于继发不孕组(P<0.05)。宫腔粘连组CD38阳性的比例高于继发不孕组(19.1%vs 10.7%),差异有统计学意义(P<0.05);宫腔粘连组CD138阳性、CD38/CD138双阳的比例与继发不孕组比较,差异均无统计学意义(P>0.05)。多因素logistic回归分析发现年龄[OR=0.876,95%CI(0.828,0.927)]、末次妊娠中的异位妊娠[OR=0.151,95%CI(0.066,0.345)]、顺产[OR=0.242,95%CI(0.085,0.686)]、剖宫产[OR=0.163,95%CI(0.048,0.554)]相对于“人流/药流”均是宫腔粘连的保护因素(P<0.05);孕次是宫腔粘连的独立危险因素[OR=1.729,95%CI(1.352,2.211),P<0.05]。结论:CD38在宫腔粘连患者子宫内膜中表现为高表达;孕次是宫腔粘连的独立危险因素,减少孕次可以减少宫腔粘连的发生。
Objective:To explore the risk factors of intrauterine adhesions in patients with intrauterine adhesions.Method:Clinical data were retrospectively collected from August 2020 to May 2021 from patients with intrauterine adhesions(188 cases)and patients with secondary infertility(149 cases)who underwent hysteroscopic surgery at Fujian Provicial Maternity and Child Health Hospital.The age,body mass index(BMI),the number of pregnancies,the number of deliveries,the number of miscarriages,last pregnancy status,and expression of CD38 and CD138 were compared between the two groups,and the factors affecting intrauterine adhesions were analyzed using logistic analysis.Result:The number of pregnancies,the number of deliveries,the number of miscarriages in the intrauterine adhesions group were significantly more than those in the secondary infertility group(P<0.05).The proportion of CD38 positivity in the intrauterine adhesions group was higher than that in the secondary infertility group(19.1%vs 10.7%),the difference was statistically significant(P<0.05).The proportion of CD138 positive and CD38/CD138 double positive in the intrauterine adhesions group compared to those the secondary infertility group,the differences were not statistically significant(P>0.05).Multivariate logistic regression analysis found that age[OR=0.876,95%CI(0.828,0.927)],ectopic pregnancy in the last pregnancy[OR=0.151,95%CI(0.066,0.345)],natural delivery[OR=0.242,95%CI(0.085,0.686)],and cesarean section[OR=0.163,95%CI(0.048,0.554)]were protective factors for intrauterine adhesions(P<0.05);the number of pregnancies was an independent risk factor for intrauterine adhesions[OR=1.729,95%CI(1.352,2.211),P<0.05].Conclusion:CD38 was highly expressed in the endometrium of patients with intrauterine adhesions;the number of pregnancies was an independent risk factor for intrauterine adhesions,and reducing unnecessary the number of pregnancies could reduce the occurrence of intrauterine adhesion.
作者
练俊誉
LIAN Junyu(Gynecology Department 1,Fujian Provincial Maternity and Child Health Hospital,Fuzhou 350005,China)
出处
《中国医学创新》
CAS
2024年第5期126-130,共5页
Medical Innovation of China
