摘要
【目的】建立一种预测输卵管性不孕(tubal factor infertility,TFI)患者生殖手术术后生育能力的模型—输卵管生育指数(fallopian fertility index,FFI),以指导患者术后妊娠方式的选择。【方法】对2014年11月—2018年12月在我院妇科病区行不孕症生殖手术治疗的591例患者进行回顾性研究,记录患者术后的妊娠结局。分析其最低输卵管功能评分(least function,LF)及各种病史因素对妊娠结局的影响,构建FFI,计算其cut-off值及灵敏度和特异度。【结果】通过单因素分析发现妊娠结局与LF差值、年龄、不孕年限有关(P=0.000、0.026和0.000),与不孕类型、流产史、异位妊娠史无关(P=0.772、0.503、0.302)。Logistic回归进行多因素分析,LF差值、年龄和不孕年限对妊娠结局有影响,其P值分别为0.000、0.010和0.000。由回归分析结果构建FFI,其cut-off值是7,ROC曲线下面积为0.770(P=0.000),灵敏度为82.5%,特异度为57.9%。【结论】通过提出LF评分系统,构建FFI。FFI能够很好地指导TFI生殖手术后的妊娠选择,当FFI≤6时,术后不能自然妊娠或异位妊娠的可能性大,可直接转行IVF。当FFI值为≥7时,术后自然妊娠的可能性大,可期待术后自然妊娠。
【Objective】To establish a new system fallopian fertility index(FFI), which leads to evaluate the pregnancy possibility of patients with tubal factor infertility(TFI) after reconstruction surgery and afford the choice to them.【Methods】The data of 591 patients with infertility who accepted reproductive surgery for infertility in the Affiliated Hospital of Logistics University of the Chinese People’s Armed Forces from November 2014 to December 2016 were retrospectively analyzed. The pregnancy outcome after reconstruction surgery was recorded. The least function(LF) score was counted, and the effect of various medical historical factors on pregnancy outcome was analyzed. A simple scoring system, FFI, was established. The cut-off, sensitivity and specificity of FFI in the predicting of pregnancy were calculated.【Results】Pregnancy outcome was related to LF difference, age and infertile years by univariate analysis(P=0.000, 0.026, 0.000). It showed no correlation with infertile type, abortion history, ectopic pregnancy history(P=0.772, 0.503, 0.302).Multivariate Logistic regression analysis showed that pregnancy outcome was significantly correlated with LF difference, age, infertile years(P=0.000, 0.010 and 0.000). FFI was established by the results of Logistic regression analysis, ranging from 2 to 10, to predict the pregnancy outcome. The cut-off was 7, and area under curve was 0.770(P=0.000). The sensitivity and specificity were 82.5% and57.9%.【Conclusion】FFI can afford pregnancy choice to the patients with TFI. When FFI≤6, the possibility of unpregnancy or ectopic pregnancy is great, so the patients can select IVF. When FFI≥7, the possibility of intrauterine pregnancy is great, the patients can selectnatural pregnancy.
作者
陈俊
邹晓萍
吴思雨
陈晓
陈亚琼
CHEN Jun;ZOU Xiao-ping;WU Si-yu;CHEN Xiao;CHEN Ya-qiong(Department of Gynaecology and Obstetrics,Characteristic Medical Center of PAP,Tianjin 300162,China)
出处
《武警后勤学院学报（医学版）》
CAS
2021年第5期20-24,共5页
Journal of Logistics University of PAP（Medical Sciences）
关键词
输卵管性不孕
输卵管生育指数
评价
生殖手术
灵敏度
特异度
Tubal factor infertility
Fallopian fertility index
Evaluation
Reconstruction Surgery
Sensitivity
Specificity
