临床误诊误治2023，Vol.36Issue(7)：109-114,6.DOI:10.3969/j.issn.1002-3429.2023.07.024
宫腔粘连发病高危因素与不孕症的相关性及对临床防治的指导
Correlation between High-risk Factors of Intrauterine Adhesions and Infer-tility and Its Guidance for Clinical Prevention and Treatment
摘要
Abstract
Objective To explore the high-risk factors for intrauterine adhesions(IUA)and to analyze the relation-ship of IUA and their high-risk factors with infertility.Methods In total,150 patients who underwent hysteroscopic examina-tion from June 2017 to June 2022 were selected for clinical data.They were divided into two groups based on the occurrence of IUA:the adhesion group and the non-adhesion group.Case data from the two groups were collected and analyzed to compare the incidence of infertility in patients undergoing hysteroscopic examination under different conditions.Multivariate Logistic re-gression analysis was used to explore the high-risk factors for IUA,and forest maps were drawn to construct a risk warning model for IUA.The predictive value of the risk warning model was analyzed based on the receiver operating characteristic(ROC)curve.Results The incidence of IUA was 26.00%(39/150),with mild adhesions accounting for 25.64%,mod-erate adhesions accounting for56.41%,and severe adhesions accounting for17.95%.The incidence of infertility in patients with IUA,history of intrauterine cavity operation,pelvic inflammation,endometritis,history of intrauterine infection,times of uterine cavity operation≥3,serum tumor necrosis factor-α(TNF-α)≥20 ng/L undergoing hysteroscopy was higher than that in patients without IUA,history of intrauterine operation,pelvic inflammation,endometritis,history of intrauterine infection,times of intrauterine operation＜3,and serum TNF-α＜20 ng/L(P＜0.05,P＜0.01).History of intrauterine operation,pelvic inflammation,endometritis,intrauterine infection,times of intrauterine operation,and serum interleukin 6(IL-6),IL-8,and TNF-α were all independent risk factors for IUA(P＜0.01).The area under the ROC curve of the risk warning model in predicting IUA was 0.923,with a sensitivity of 79.49%and a specificity of 98.20%.Conclusion There are many influencing factors for the incidence of IUA,and patients with IUA combined with high-risk factors have a high risk of infertil-ity.Building a risk warning model for IUA and taking timely preventive measures are expected to become a new approach to improvement of female reproductive health.关键词
宫腔粘连/危险因素/不孕症/预测/子宫内膜炎/盆腔炎性疾病/肿瘤坏死因子-α/白细胞介素-6Key words
Intrauterine adhesions/Risk factors/Infertility/Prediction/Endometritis/Pelvic inflammatory disease/Tumor necrosis factor-α/Interleukin-6分类
临床医学引用本文复制引用
赵郡,张蕾,马晓琳,王莹倩..宫腔粘连发病高危因素与不孕症的相关性及对临床防治的指导[J].临床误诊误治,2023,36(7):109-114,6.基金项目
2019年度河北省医学科学研究课题计划项目(20190668) （20190668）
