基于决策曲线和剂量反应分析视黄醇结合蛋白4对子宫内膜增生症患者孕激素治疗效果的预测价值  

Predictive value of retinol-binding protein 4 on the treatment effect of progesterone therapy in patients with endometrial hyperplasia based on decision curve and dose-response analysis

作　　者：赵佳丽 杨粉丽 李曹菲 陈群 杨锐 ZHAO Jiali;YANG Fenli;LI Caofei;CHEN Qun;YANG Rui(Department of Obstetrics and Gynecology Emergency,Northwest Women′s and Children′s Hospital,Xi′an 710061,Shaanxi,China;Department of Gynecologic Endocrinology Gynecaceae,Northwest Women′s and Children′s Hospital,Xi′an 710061,Shaanxi,China)

机构地区：[1]西北妇女儿童医院妇产科急诊,西安710061 [2]西北妇女儿童医院妇科内分泌科,西安710061

出　　处：《中国性科学》2024年第12期66-70,共5页Chinese Journal of Human Sexuality

摘　　要：目的基于决策曲线和剂量反应分析视黄醇结合蛋白4(RBP4)对子宫内膜增生症患者孕激素治疗效果的预测价值。方法回顾性选取2020年3月至2023年2月西北妇女儿童医院诊治的133例子宫内膜增生患者作为研究对象,根据患者治疗结果分为有效组(n=114)和无效组(n=19)。比较患者孕酮、雌二醇、黄体生成素、卵泡刺激素及RBP4水平;采用Logistic回归分析孕激素治疗效果的影响因素;采用决策曲线及剂量反应分析RBP4对子宫内膜增生症患者孕激素治疗效果的预测价值。结果与无效组比较,有效组孕酮、卵泡刺激素、雌二醇、黄体生成素、RBP4水平均显著降低(P<0.01)。经Logistic回归分析,孕酮、雌二醇、黄体生成素、卵泡刺激素、RBP4水平均为子宫内膜增生症患者孕激素治疗效果的危险因素(P<0.05)。经决策曲线分析,阈值在0.4~0.6时,RBP4在预测子宫内膜增生症患者孕激素治疗效果方面具有较高价值。RBP4与子宫内膜增生症患者孕激素治疗效果的关联强度呈线性剂量反应关系(P<0.05)。结论RBP4水平对子宫内膜增生症患者孕激素治疗效果具有一定预测价值,且其与患者治疗效果呈现一定的线性剂量反应关系。Objective To analyze the predictive value of retinol-binding protein 4(RBP4)on treatment effect of progesterone therapy in patients with endometrial hyperplasia based on decision curve and dose-response analysis.Methods A total of 133 patients of endometrial hyperplasia admitted to Northwest Women′s and Children′s Hospital from March 2020 to February 2023 were retrospectively selected,and were divided into effective group(n=114)and ineffective group(n=19)according to the treatment results of the patients.The levels of progesterone,estradiol,luteinizing hormone,follicle stimulating hormone,and RBP4 in patients were compared.Logistic analysis was used to analyze factors influencing the treatment effect of progesterone therapy.Decision curve and dose-response analysis of RBP4 were used to analyze predicting value of RBP4 on treatment effect of progesterone treatment in patients with endometrial hyperplasia Results Compared with the ineffective group,the effective group had significantly decreased levels of progesterone,follicle stimulating hormone,estradiol,luteinizing hormone,and RBP4(P<0.01).Logistic regression analysis showed that progesterone,estradiol,luteinizing hormone,follicle stimulating hormone,and RBP4 were all risk factors for progesterone treatment effect in patients with endometrial hyperplasia(P<0.05).According to decision curve analysis,RBP4 had high value in predicting the treatment effect of progesterone therapy in patients with endometrial hyperplasia when the threshold was at 0.4-0.6.The correlation strength between RBP4 and the treatment effect of progesterone therapy in patients with endometrial hyperplasia showed a linear dose-response relationship(P<0.05).Conclusions The detection of RBP4 levels has certain predictive value for the treatment effect of progesterone in patients with endometrial hyperplasia,and there is a linear dose-response relationship between it and the patient′s treatment effect.

关 键 词：决策曲线 剂量反应 视黄醇结合蛋白4 子宫内膜增生症 孕激素 治疗效果 

分 类 号：R711[医药卫生—妇产科学]