手术难度评分系统联合血清炎性因子IL-2、IL-4、IL-10对子宫肌瘤剔除术后不良妊娠结局的预测价值  

Predictive value of surgical difficulty scoring system combined with serum inflammatory factors IL-2,IL-4,and IL-10 for adverse pregnancy outcomes after myomectomy

作　　者：马松雅[1] 魏松辉 陶月龄 MA Songya;WEI Songhui;TAO Yueing(Department of Obstetrics and Gynecology,Pingdingshan First People's Hospital,Henan 467000,China)

机构地区：[1]平顶山市第一人民医院妇产科,河南467000

出　　处：《西南医科大学学报》2024年第5期433-437,共5页Journal of Southwest Medical University

基　　金：河南省医学科技攻关项目(LHGJ20220968)。

摘　　要：目的分析手术难度评分系统(difficulty degreeindex,DDI)联合血清炎性因子白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)对子宫肌瘤剔除术后不良妊娠结局中的预测价值。方法选择平顶山市第一人民医院2020年3月至2022年8月行腹腔镜下子宫肌瘤剔除术并有生育要求的患者168例。随访至2023年12月31日,根据患者术后妊娠结局情况将其分为术后正常妊娠组(133例)及术后不良妊娠组(35例)。评估并比较两组DDI评分及血清IL-2、IL-4、IL-10水平。收集患者相关临床资料及实验室检查相关指标,采用Lo⁃gistic回归分析影响子宫肌瘤剔除术后不良妊娠结局的危险因素。采用受试者工作特征曲线(ROC)计算曲线下面积(AUC),评估DDI评分联合血清IL-2、IL-4、IL-10对子宫肌瘤剔除术后不良妊娠结局的风险预测价值。结果与术后正常妊娠组相比,术后不良妊娠组患者DDI评分和血清IL-2水平更高(P<0.05),血清IL-4和IL-10水平更低(P<0.05);单因素分析结果显示,术后不良妊娠组患者年龄、多发肌瘤、肌瘤复发、肌瘤最大直径、术前有盆腔粘连病史占比高于术后正常妊娠组(P<0.05);Logistic多因素分析结果显示,年龄、DDI评分、血清IL-2、IL-4、IL-10均为子宫肌瘤剔除术后不良妊娠结局的危险因素(P<0.05)。ROC曲线分析结果显示,DDI评分联合血清IL-2、IL-4、IL-10预测子宫肌瘤剔除术后不良妊娠结局风险的敏感度、准确度及AUC分别为90.82%、84.18%、0.823均高于DDI评分、血清IL-2、IL-4、IL-10单独预测,DDI评分联合血清IL-2、IL-4、IL-10预测子宫肌瘤剔除术后不良妊娠结局风险的特异度为75.26%,低于单一指标预测。结论DDI评分、血清IL-2、IL-4、IL-10均为子宫肌瘤剔除术后不良妊娠结局的危险因素,可在一定程度上预测子宫肌瘤剔除术后不良妊娠结局。Objective To analyze the predictive value of surgical difficulty scoring system(difficulty degree index,DDI)com-bined with serum inflammatory factors interleuKin-2(IL-2),interleuKin-4(IL-4),and interleuKin-10(IL-10)in adverse preg-nancy outcomes after hysteromyomectomy.Methods A total of 168 patients with fertility requirements who underwent laparoscopic myomectomy from March 2020 to August 2022 were selected from the hospital.Follow-up was conducted until December 31,2023,and the patients were divided into normal pregnancy group and adverse pregnancy group according to their postoperative pregnancy out-comes.DDI scores and serum levels of IL-2,IL-4,and IL-10 were evaluated and compared between the two groups.Relevant clinical data and laboratory examination indicators were collected,and the risk factors affecting adverse pregnancy outcomes after myomectomy were analyzed by Logistic regression.The area under the curve(AUC)was calculated using the receiver operating characteristic curve(ROC)to evaluate the predictive value of DDI score combined with serum IL-2,IL-4,and IL-10 for the risk of adverse pregnancy out-comes following hysteromyomectomy.Results Compared with the normal pregnancy group,DDI score and serum IL-2 in the adverse pregnancy group were higher(P<0.05),and serum IL-4 and IL-10 were lower(P<0.05)。Univariate analysis showed that the pro-portion of age,multiple fibroids,recurrence of fibroids,maximum diameter of fibroids,and history of pelvic adhesion before operation in the adverse pregnancy group were higher than that in the normal pregnancy group(P<0.05)。Logistic multivariate analysis showed that age,DDI score,serum IL-2,IL-4,and IL-10 were all risk factors for adverse pregnancy outcomes after myomectomy(P<0.05)。ROC curve analysis results showed that the sensitivity,accuracy,and AUC of DDI score combined with serum IL-2,IL-4,and IL-10 in predicting the risk of adverse pregnancy outcomes after hysteromyomectomy were 90.82%,84.18%,and 0.823,respectively,which were higher than those of the DDI s

关 键 词：子宫肌瘤剔除术 妊娠结局 手术难度评分系统 白细胞介素 预测价值 

分 类 号：R737.33[医药卫生—肿瘤]