Abstract
Objective:To analyze the influencing factors of postoperative premature ovarian failure in patients with uterine fibroids and hypertension,and to construct a column chart model.
Methods:Patients with uterine fibroids and hypertension admitted to Shanghai First Maternity and Infant Hospital from January 2020 to March 2024 were selected as the research subjects.According to the occurrence of premature ovarian failure,they were divided into the premature ovarian failure group(n=29)and the non premature ovarian failure group(n=482).Clinical data of the patients were collected.Multivariate logistic regression analysis on the influencing factors of postoperative ovarian premature failure in patients with uterine fibroids and hypertension was conducted,and the RMS package in R software was used to draw a column chart model,and internal validation was performed by repeating 1 000 sampling with the Bootstrap method.The effectiveness of the model was verified through a receiver operating characteristic(ROC)curve,calibration curve,and DC A curve.
Results:A total of 511 patients with uterine fibroids combined with hypertension were included,and after six months of follow-up post-surgery,29 patients developed premature ovarian failure,with an incidence rate of 5.68％.The results of the logistic regression analysis showed that smoking[OR=2.924,95％CI(1.534,5.572),P=0.001],sleep quality[OR=3.888,95％CI(2.536,5.961),P＜0.001],physical exercise[OR=0.393,95％CI(0.229,0.674),P=0.001],type A personality[OR=3.219,95％CI(1.478,7.008),P=0.003],anxiety[OR=3.142,95％CI(1.131,8.725),P=0.028],depression[OR=3.564,95％CI(1.215,10.454),P=0.021],family history of premature ovarian failure[OR=2.408,95％CI(1.372,4.227),P=0.002],history of ovarian surgery[OR=3.463,95％CI(1.397,8.580),P=0.008],and induced abortion[OR=2.291,95％CI(1.500,3.499),P＜0.001]were independent influencing factors for postoperative premature ovarian failure in patients with uterine fibroids combined with hypertension(P＜0.05).The nomogram model for predicting postoperative premature ovarian failure in patients with uterine fibroids combined with hypertension,based on the results of the multi-factorial logistic regression analysis,showed an area under the curve of 0.892[95％CI(0.832,0.952)],with a sensitivity of 90.90％and specificity of 75.60％.The Hosmer-Lemeshow goodness-of-fit test results indicated that the predictive model of this nomogram fitted well(x2=5.994,P=0.081).The DCA curve analysis results showed that when the threshold was less than 0.96,this nomogram predictive model had a good clinical net benefit rate.
Conclusions:Smoking,sleep quality,physical exercise,type A personality,anxiety,depression,family history of premature ovarian failure,history of ovarian surgery,and induced abortion are independent influencing factors of postoperative premature ovarian failure in patients with uterine fibroids and hypertension.They should be highly valued in clinical practice.The column chart prediction model constructed above could help predict the risk of postoperative premature ovarian failure in patients with uterine fibroids and hypertension early,and better guide clinical doctors to identify the occurrence of postoperative premature ovarian failure and intervene in a timely manner.关键词
卵巢早衰/子宫肌瘤/高血压/影响因素/列线图Key words
Premature ovarian failure/Uterine fibroid/Hypertension/Influencing factors/Column chart分类
医药卫生
