TCRA术后患者行冻融胚胎移植活产预测模型的构建  

A prediction model of live birth in patients undergoing frozen-thawed embryo transfer after TCRA

作　　者：李紫薇 王影[1,2,3] 邢琼 章志国[1,2,3] 曹云霞 魏兆莲[1,2,3] 王建业 Li Ziwei;Wang Ying;Xing Qiong;Zhang Zhiguo;Cao Yunxia;Wei Zhaolian;Wang Jianye(Reproductive Medicine Center,Dept of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Anhui Province Key Laboratory of Reproductive Health and Genetics,Anhui Medical University,Hefei 230032;NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract,Hefei 230032)

机构地区：[1]安徽医科大学第一附属医院妇产科生殖医学中心,合肥230022 [2]安徽医科大学生殖健康与遗传安徽省重点实验室,合肥230032 [3]安徽省生命资源保存与人工器官工程技术研究中心,合肥230032

出　　处：《安徽医科大学学报》2023年第11期1947-1951,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81901437、82171619)。

摘　　要：目的基于宫腔粘连松解术(TCRA)后患者冻融胚胎移植(F-ET)的基本信息建立活产预测模型。方法选取491个TCRA术后进行F-ET治疗的周期,以7∶3随机分为训练集(n=347)和验证集(n=144),首先基于训练集数据通过单因素逻辑回归筛选出相关影响因素,再纳入多因素逻辑回归分析建立列线图模型,并对预测模型进行校准与验证。结果年龄、体质指数(BMI)、流产史、子宫内膜厚度与活产显著相关。根据上述指标建立列线图,训练集的ROC曲线下面积为0.713(95%CI:0.519~0.815),Hosmer-Lemeshow拟合优度检验结果为χ^(2)=7.062,P=0.530,校准曲线观察斜率接近1,验证集的ROC曲线下面积为0.609(95%CI:0.660~0.561)。模型具有良好的拟合效果和稳定性。结论基于年龄、BMI、流产史和子宫内膜厚度建立的列线图模型可较好地预测TCRA术后患者F-ET的活产概率。Objective To develop a prediction model for live birth based on the basic characters of patients after transcervical resection of adhesions(TCRA)undergoing frozen-thawed embryo transfer(F-ET).Methods A total of 491 cycles who went F-ET after TCRA were included.The cycles were randomly divided into training(n=347)and validation(n=144)cohorts at 7∶3 ratio.Relevant factors of live birth were selected via logistic regression analysis based on the data from patients in the training cohort.Multivariate logistic regression analysis was used to establish a nomogram,and then this predict model was calibrated and verified.Results Age,body mass index(BMI),miscarriages and endometrial thickness were significantly related to the live birth.The statistical nomogram was built with the area under the ROC curve for the training cohort was 0.713(95%CI:0.519-0.815),Hosmer-Lemeshow goodness of fit test wereχ^(2)=7.062,P=0.530,and the slope of calibration curve was close to 1.AUC of validation cohort was 0.609(95%CI:0.660-0.561),presenting a well-pleasing goodness-of-fit and stability in this model.Conclusion Age,BMI,miscarriages and endometrial thickness can better predict the probability of live birth undergoing F-ET after TCRA.

关 键 词：宫腔粘连松解术 影响因素 预测模型 胚胎移植 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]