子宫内膜息肉复发因素分析及预测模型建立  

Analysis of Recurrence Factors of Endometrial Polyps and Establishment of Prediction Model

作　　者：周伟伟 葛小花[1] ZHOU Weiwei;GE Xiaohua(Department of Obstetrics and Gynecology,Chaohu Hospital of Anhui University,Chaohu 238000,Anhui,China)

机构地区：[1]安徽医科大学附属巢湖医院妇产科,安徽巢湖238000

出　　处：《医学信息》2025年第8期92-95,117,共5页Journal of Medical Information

摘　　要：目的 探讨基于森林图构建的子宫内膜息肉(EP)复发危险因素预警模型的预测价值。方法 选取2022年1月-2023年1月安徽医科大学附属巢湖医院收治的98例接受宫腔镜下子宫内膜息肉切除术(TCRP)后的患者进行随访,根据术后情况分为复发组和未复发组。应用Logistic分析患者术后复发的危险因素,构建复发预警模型,分析模型的预测价值。结果 单因素结果显示,年龄≥40岁、体重指数≥28 kg/m^(2)、合并子宫肌瘤、术后未处理是EP患者术后复发的影响因素(P<0.05);多因素Logistic显示,体重指数≥28 kg/m^(2)、合并子宫肌瘤、术后未应用孕激素类药物是EP复发的独立危险因素(P<0.05);术后使用孕激素及曼月乐环是TCRP后复发的独立保护因素;森林图显示体重指数≥28 kg/m^(2)、合并子宫肌瘤、术后未处理均为正相关危险因素,与无效线不相交(P<0.05);以森林图为基准构建风险预警模型,经Hosmer-Lemeshow拟合优度检验,模型拟合效果良好,受试者工作特征(ROC)曲线显示,AUC为0.887(95%CI:0.808~0.967),敏感度为73.80%,特异度为92.90%。结论 基于森林图构建的子宫内膜息肉复发危险因素预警模型具有良好的预测价值,能为临床及早采取针对性预防复发措施提供可靠依据。Objective To explore the predictive value of early warning model of risk factors for recurrence of endometrial polyps(EP) based on forest map.Methods A total of 98 patients who underwent transcervical polyp resection(TCRP) in Chaohu Hospital of Anhui Medical University from January 2022 to January 2023 were selected for follow-up.According to the postoperative conditions,they were divided into recurrence group and non-recurrence group.Logistic analysis was used to analyze the risk factors of postoperative recurrence,and a recurrence warning model was constructed to analyze the predictive value of the model.Results Univariate results showed that age ≥40 years old,body mass index ≥28 kg/m^(2),combined with uterine fibroids,and postoperative untreated were the influencing factors of postoperative recurrence in EP patients( P <0.05).Multivariate Logistic analysis showed that body mass index ≥28 kg/m^(2),uterine fibroids,and no use of progesterone drugs after surgery were independent risk factors for EP recurrence(P <0.05).Postoperative use of progesterone and Mirena ring were independent protective factors for recurrence after TCRP.The forest map showed that body mass index ≥ 28 kg/m^(2),uterine fibroids,and postoperative untreated were all positively correlated risk factors,which did not intersect with the invalid line(P<0.05).The risk early warning model was constructed based on the forest map.The Hosmer-Lemeshow goodness of fit test showed that the model had a good fitting effect.The receiver operating characteristic(ROC) curve showed that the AUC was 0.887(95%CI:0.808-0.967),the sensitivity was 73.80%,and the specificity was 92.90%.Conclusion The early warning model of risk factors for recurrence of endometrial polyps based on forest map has good predictive value,which can provide a reliable basis for clinical early targeted prevention and recurrence measures.

关 键 词：子宫内膜息肉 复发危险因素 森林图 预测模型 

分 类 号：R711.32[医药卫生—妇产科学]