复发性流产影响因素分析及预测模型的构建  

Analysis of Influencing Factors of Recurrent Abortion and Construction of Prediction Model

作　　者：李娜[1] 李丹[1] LI Na;LI Dan(Department of Reproductive Genetics, Peace Hospital, Changzhi Medical College)

机构地区：[1]长治医学院附属和平医院生殖遗传科,山西长治046000

出　　处：《长治医学院学报》2024年第4期277-281,共5页Journal of Changzhi Medical College

基　　金：山西省卫健委生殖工程委级重点实验室(2021SYS21);山西省卫健委科研项目(2022134)。

摘　　要：目的:基于复发性流产影响因素构建预测模型并评估其效能。方法:选取复发性流产患者和同期入院体检的已生育健康女性各80例,分别作为观察组和对照组。比较2组自身免疫性抗体[抗精子抗体(ASAb)、抗子宫内膜抗体(AEMAb),抗心磷脂抗体(ACAb)及抗卵巢抗体(AOAb)]、抗苗勒氏管激素(AMH)水平及男性伴侣中精浆生化三项差异;采用多因素Logistic回归构建预测模型,并绘制受试者工作特征(ROC)曲线评价其预测能力。结果:观察组女性血清ASAb、AEMAb、ACAb、AOAb水平高于对照组,而AMH水平低于对照组;观察组男性伴侣中果糖、精浆锌、α葡萄糖苷酶较对照组低(P<0.05);多因素Logistic回归结果显示,血清ASAb、AEMAb、ACAb、AOAb、AMH水平及果糖、精浆锌、α葡萄糖苷酶均是复发性流产发生的影响因素(OR=3.476、3.180、3.364、3.203、2.651、2.617、2.596、2.633,P<0.05);ROC曲线分析显示,自身免疫性抗体、AMH及精浆生化指标联合预测模型预测复发性流产的曲线下面积(0.985)最高,灵敏度、特异度分别为96.25%和91.25%。结论:自身免疫性抗体、AMH及果糖、精浆锌、α葡萄糖苷酶是复发性流产的影响因素,基于其构建的预测模型,对复发性流产具有较高的预测效能。Objective:To construct a prediction model and evaluate its effectiveness based on the influencing factors of recurrent abortion.Methods:80 patients with recurrent abortion and 80 healthy women who were admitted to hospital for physical examination at the same period were selected as observation group and control group,respectively.The levels of autoimmune antibodies(anti-sperm antibody(ASAb),anti-endometrial antibody(AEMAb),anticardiolipin antibody(ACAb) and anti-ovarian antibody(AOAb)),anti-Mullerian hormone(AMH) and the male partners of biochemical three items of seminal plasma were compared between the two groups.Multivariate Logistic regression was used to construct the prediction model,and receiver operating characteristic(ROC) curve was drawn to evaluate their prediction ability.Results:The serum levels of ASAb,AEMAb,ACAb and AOAb in the observation group were higher than those in the control group,while the levels of AMH were lower than that in the control group.The levels of fructose,seminal plasma zinc and α glucosidase in male partners in observation group were lower than those in control group(P<0.05).Multivariate Logistic regression analysis showed that serum levels of ASAb,AEMAb,ACAb,AOAb,AMH,as well as fructose,seminal plasma zinc and α glucosidase were all influencing factors of recurrent abortion(OR=3.476,3.180,3.364,3.203,2.651,2.617,2.596,2.633,P<0.05).ROC curve analysis showed that the area under the curve of the predictive model based on autoimmune antibody,AMH and seminal plasma biochemical indexes was 0.985,and the sensitivity and specificity were 96.25% and 91.25%,respectively(P<0.05).Conclusion:Autoimmune antibody,AMH and fructose,seminal plasma zinc,α glucosidase were all influencing factors of recurrent abortion,the pledic model has high prediction efficiency for recurrent abortion.

关 键 词：复发性流产 自身免疫抗体 AMH 精浆指标 预测模型 

分 类 号：R714.21[医药卫生—妇产科学]