摘要
目的 探讨外周血辅助性17细胞(Th17)、调节性T细胞(Treg)、术前系统免疫炎症指数(SII)对卵巢子宫内膜异位囊肿(OEM)患者腹腔镜手术后自然妊娠的预测价值。方法 选取2018年9月至2021年9月在昆山市中医医院行腹腔镜手术治疗的OEM患者104例,全部患者在术后均随访两年时间,根据患者的自然妊娠结局进行分组,分为妊娠成功组(n=45)和妊娠失败组(n=59),采用多因素Logistic回归分析影响OEM患者妊娠结局的因素,并绘制受试者工作特征(ROC)曲线分析术前SII、Th17、Treg、Th17/Treg及联合检测对妊娠结局的预测价值。结果 104例OEM患者中45例自然妊娠成功,59例自然妊娠失败。两组比较,年龄、囊肿类型、AMH、糖类抗原125、sp17Ab、Th17、Treg、SII、Th17/Treg等差异均有统计学意义(P <0.05)。将上述危险因素进行Logistic回归分析,结果显示AMH、sp17Ab、Treg、Th17、SII、Th17/Treg是OEM患者术后自然妊娠失败的危险因素。ROC曲线显示,Th17、Treg、Th17/Treg、SII、联合预测不良预后的曲线下面积分别为0.730、0.583、0.935、0.776、0.955。结论 OEM患者在术前的Th17、Treg、SII水平对术后自然妊娠结局有一定的预测价值。
Objective To investigate the predictive value of Th17 cells,Treg cells and systemic immune inflammatory index(SII)in patients with ovarian endometriosis(OEM)after laparoscopic surgery.Methods A total of 104 OEM patients undergoing laparoscopic surgery in our hospital from September 2018 to September 2021 were selected.All patients were followed up for two years after surgery.They were divided into pregnancy success group(n=45)and pregnancy failure group(n=59)according to their natural pregnancy outcome.Multivariate Logistic regression was used to analyze the factors affecting pregnancy outcomes in OEM patients,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of preoperative SII,Th17,Treg,Th17/Treg and combined tests on pregnancy outcomes.Results Among 104 OEM patients,45 were successful and 59 failed in natural pregnancy.There were significant differences in age,cyst type,AMH,carbohydrate antigen 125,sp17Ab,Th17,Treg,SII,Th17/Treg between the two groups(P<0.05).Logistic regression analysis of these risk factors revealed AMH,sp17Ab,Treg,Th17,SII,Th17/Treg were risk factors for spontaneous pregnancy failure in OEM patients.ROC curves showed that the areas under the curves for Th17,Treg,Th17/Treg,SII,and combination predicting poor prognosis were 0.730,0.583,0.935,0.776,and 0.955,respectively.Conclusion Preoperative Th17,Treg and SII levels in OEM patients have important predictive value for postoperative natural pregnancy outcome.
作者
李彩霞
周琴
丁爱娟
LI Caixia;ZHOU Qin;DING Aijuan(Department of Gynecology,Kunshan Hospital of Traditional Chinese Medicine,Kunshan Jiangsu 215316,China)
出处
《中国妇产科临床杂志》
CSCD
北大核心
2024年第5期425-428,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
江苏省卫健委项目(Z2021089)
苏州科技发展项目(SYS2020034)。
