摘要
目的:分析子宫内膜息肉患者术前血清CXC类趋化因子配体12(CXCL12)、CXC类趋化因子受体4(CXCR4)水平及与切除术后宫腔粘连发生关系。方法:选择2021年1月-2023年1月本院收治并行宫腔镜下子宫内膜息肉冷刀切除术的患者86例临床资料,根据术后1年随访分为宫腔粘连组(n=33)、非宫腔粘连组(n=53)。患者术前入院后24h内检测血清CXCL12、CXCR4水平,采用受试者工作特征曲线(ROC)评估血清CXCL12、CXCR4对息肉切除术后宫腔粘连发生的评估价值,采用二分类logistic逐步回归分析术后粘连发生相关因素。结果:宫腔粘连组手术时间、孕次、剖宫产史、刮宫史、宫内节育器占比、盆腔炎史、内膜增生占比、息肉直径均高于非宫腔粘连组(P<0.05)。宫腔粘连组术前血清CXCL12(11.47±2.84pg/L)、CXCR4(50.61±10.02pg/L)均高于非宫腔粘连组(5.66±1.24pg/L、23.26±5.69pg/L)(均P<0.05)。ROC曲线分析显示,子宫内膜息肉患者术前血清CXCL12、CXCR4水平及两项联合评估切除术后宫腔粘连发生的曲线下面积分别为0.854、0.866、0.925;二分类logistic逐步回归分析显示,孕次多、刮宫史、盆腔炎史及血清CXCL12、CXCR4水平升高均为子宫内膜息肉患者切除术后宫腔粘连发生的危险因素(均P<0.05)。结论:子宫内膜息肉切除术前患者血清CXCL12、CXCR4水平升高为术后宫腔粘连发生的危险因素,二者联合对评估术后宫腔粘连发生有较高效能。
Objective:To correlation between the levels of the preoperative serum CXC-class chemokine ligand 12(CXCL12)and CXC-class chemokine receptor 4(CXCR4)of patients with endometrial polyps and their intrauterine adhesions after the endometrial polypectomy.Methods:The clinical data of 86 patients who had undergone hysteroscopic cold knife resection of endometrial polyps from January 2021 to January 2023 were selected in this study.These patients were divided into group A(33 cases with intrauterine adhesion)and group B(53 cases without intrauterine adhesion)according to the results of the follow-up in the postoperative 1 year.The serum CXCL12 and CXCR4 levels of the patients in the two groups were detected within 24h after admission.Receiver operating characteristic(ROC)curve was used to evaluate the value of the serum CXCL12 and CXCR4 levels of the patients for their intrauterine adhesion after polypectomy.Binary logistic stepwise regression was used to analyze the related factors of the postoperative adhesion of the patients.Results:The operation time,the gravidity,the history of cesarean section,the history of curettage,the proportion of intrauterine device used,the history of pelvic inflammatory disease,the proportion of endometrial hyperplasia and the polyp diameter of the patients in group A were significantly higher than those of the patients in group B(P<0.05).The levels of preoperative serum CXCL12(11.47±2.84pg/L)and CXCR4(50.61±10.02pg/L)of the patients in group A were significantly higher than those(5.66±1.24pg/L and 23.26±5.69pg/L)of the patients in group B(all P<0.05).ROC curve analysis showed that the area under the curve of the preoperative serum CXCL12level,the CXCR4level and the combination of the CXCL12and CXCR4levels of the patients with endometrial polyps for evaluating the occurrence of their intrauterine adhesion after the polyp's resection were 0.854,0.866and 0.925,respectively.Binary logistic stepwise regression analysis showed that the multiple pregnancies,the history of curettage,the pelvic
作者
王跃
宋航
吕品
WANG Yue;SONG Hang;LV Pin(The Fifth People's Hospital of Wuxi,Wuxi,Jiangsu Province,214000;Lianyungang Maternal and Child Health Care Hos pital;Nanjing Brain Hospital)
出处
《中国计划生育学杂志》
2024年第10期2372-2376,共5页
Chinese Journal of Family Planning
关键词
子宫内膜息肉冷刀切除术
CXC类趋化因子配体12
CXC类趋化因子受体4
术后宫腔粘连发生
影响因素
评估
Hysteroscopic cold knife resection of endometrial polyps
CXC chemokine ligand 12
CXC chemokine re-ceptor 4
Endometrial polyps
Occurrence of the postoperative intrauterine adhesions
Influence factor
Evaluation
