术前雌激素、孕激素水平与稽留流产清宫术后宫腔粘连发生的关系及其预测价值  

Relationship between estrogen and progesterone levels and intrauterine adhesions after uterine evacuation in patients with missed abortion and its predictive value

作　　者：王军[1] 宋晓霞 王佳佳[2] 张占薪 苏倩倩 张博慧 吴启文 郭伟平 WANG Jun;SONG Xiaoxia;WANG Jiajia;ZHANG Zhanxin;SU Qianqian;ZHANG Bohui;WU Qiwen;GUO Weiping(Department of Gynecology;Department of Pathology,the Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People′s Hospital),Zhengzhou,Henan 450000,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)妇科,河南郑州450000 [2]河南中医药大学第五临床医学院(郑州人民医院)病理科,河南郑州450000

出　　处：《检验医学与临床》2024年第2期174-177,182,共5页Laboratory Medicine and Clinic

基　　金：河南省医学科技攻关计划项目(LHGJ20220794)。

摘　　要：目的探讨雌激素、孕激素水平与稽留流产(MA)患者清宫术后发生宫腔粘连(IUA)的关系及其预测价值。方法选取2019年1月至2022年1月在该院妇科就诊行清宫术的128例MA患者作为研究对象,根据术后6个月内宫腔检查情况分为未发生IUA组(MA组,97例)和IUA组(31例),并根据严重程度将IUA组分为轻、中和重度IUA组。比较IUA组和MA组,以及不同严重程度IUA组术前雌二醇(E 2)和孕酮(P)水平,采用多因素Logistic回归分析发生IUA的独立影响因素;分析E 2、P与IUA病情的相关性,采用受试者工作特征(ROC)曲线分析E 2、P水平对发生IUA及其病情严重程度的预测价值。结果IUA组E 2、P水平均明显低于MA组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,E 2为MA清宫术后发生IUA的独立影响因素(P<0.05);术前E 2和P水平预测MA清宫术后发生IUA的曲线下面积分别为0.714和0.702。重度IUA组E 2、P水平均明显低于轻、中度IUA组,差异均有统计学意义(P<0.05),且E 2、P水平与IUA严重程度均呈负相关(P<0.05);术前E 2、P水平预测IUA轻/中度和重度的曲线下面积分别为0.845和0.923。结论E 2、P水平与MA清宫术后IUA的发生及严重程度均相关,对临床预测MA清宫术后IUA的发生及病情进展具有一定的参考价值。Objective To investigate the relationship between estrogen and progesterone levels and intrauterine adhesions(IUA)after uterine evacuation in patients with missed abortion(MA)and its predictive value.Methods A total of 128 patients with MA who underwent uterine clearance in the department of Gynecology of the hospital from January 2019 to January 2022 were selected as the research objects.According to the uterine examination within 6 months after surgery,they were divided into non-IUA group(MA group,97 cases)and IUA group(31 cases),and the IUA group was divided into mild,moderate and severe IUA groups according to the severity.The preoperative estradiol(E 2)and progesterone(P)levels were compared between the IUA group and the MA group,and between the IUA groups with different severity of IUA.Multivariate Logistic regression was used to analyze the independent influencing factors of IUA occurrence.The correlation between E 2,P and IUA was analyzed,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of E 2 and P levels for the occurrence and severity of IUA.Results The levels of E 2 and P in IUA group were significantly lower than those in MA group(P<0.05).Multivariate Logistic regression analysis showed that preoperative E 2 was an independent influencing factor for the occurrence of IUA after MA curettage surgery(P<0.05).The area under the curve of preoperative E 2 and P levels for predicting IUA after MA curettage surgery was 0.714 and 0.702 respectively.The levels of E 2 and P in the severe IUA group were significantly lower than those in the mild and moderate IUA groups,and the differences were statistically significant(P<0.05).The levels of E 2 and P were negatively correlated with the severity of IUA(P<0.05).The areas under the curve of preoperative E 2 and P levels for predicting mild/moderate and severe IUA were 0.845 and 0.923 respectively.Conclusion The levels of E 2 and P are correlated with the occurrence and severity of postoperative IUA in patients with MA cur

关 键 词：稽留流产 清宫术 宫腔粘连 雌激素 孕激素 

分 类 号：R714.21[医药卫生—妇产科学]