| 刘俊容.术前系统免疫炎症指数水平对卵巢子宫内膜异位囊肿合并不孕病人术后自然妊娠结局的影响[J].安徽医药,2023,27(11):2224-2228. |
| 术前系统免疫炎症指数水平对卵巢子宫内膜异位囊肿合并不孕病人术后自然妊娠结局的影响 |
| Correlation of preoperative systemic immune-inflammation index with natural pregnancy outcome of infertile patients with endometriosis |
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| DOI：10.3969/j.issn.1009-6469.2023.11.023 |
| 中文关键词: 子宫内膜异位症 不孕症 自然妊娠 炎症指标 |
| 英文关键词: Endometriosis Infertility Natural pregnancy Inflammation marker |
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| 中文摘要: |
| 目的探讨术前系统免疫炎症指数( SII)水平对卵巢子宫内膜异位囊肿( OMA)合并不孕病人术后自然妊娠结局的影响。方法选取 2015年 1月至 2020年 12月在邯郸市中医院妇科接受腹腔镜手术并且经病理确诊为 OMA的病人 208例，分为未妊娠组 102例与妊娠组 106例。收集病人的临床资料及血液指标， SII定义为(血小板计数 ×中性粒细胞绝对值) /淋巴细胞绝对值。应用 Cox回归分析确定术前 SII对病人术后妊娠结局的独立预测价值。应用受试者操作特征( ROC)曲线与 HosmerLemeshow检验评估术前 SII的预测准确性与一致性，并与内异症生育指数( EFI)进行比较。评估术前 SII与病人术后抗苗勒氏管激素( AMH)变化的相关性。结果与未妊娠组病人相比，妊娠组病人的年龄显著较小［(30.3±3.9)岁比( 31.8±4.1)岁］、不孕年限显著较短［ 2(1，3)年比 2(2，4)年］而术前 AMH［4.0(2.0，4.5)μg/L比 2.3(2.0，4.0)μg/L］与 SII［426(323，620)比 314(248， 413)］显著较高( P<0.05)。多因素分析结果，显示，术前 AMH>2 μg/L［OR=2.24，95%CI:(1.15，4.34)］与术前 SII>380［(OR= 5.93， 95%CI:(3.15，11.18)］是术后自然妊娠的独立预测因素( P<0.05)。术前 SII结合 AMH预测术后妊娠结局的准确性( AUC=0.76)与一致性( P>0.05)良好，其临床效能优于 EFI。另外，高 SII病人的术后中位 AMH(3.7 μg/L比 3.2 μg/L)与低 SII病人相比显著较高(P<0.05)。结论术前 SII与 OMA合并不孕病人术后的自然妊娠结局密切相关，可以作为临床决策的重要依据。 |
| 英文摘要: |
| Objective To investigate the impact of preoperative systemic immune-inflammation index (SII) on the natural pregnancy outcome of infertile patients with ovarian endometrioma (OMA).Methods Two-hundred and eight OMA patients confirmed by histopathology who underwent laparoscopic surgery at the TCM Hospital of Handan were enrolled between January 2015 and December 2020.Clinical features and blood parameters were collected. Cox regression analysis was used to identify the independent predictive value ofSII for postoperative pregnancy outcome. The accuracy and good fit of SII were evaluated by using receiver operating characteristiccurve and Hosmer-Lemeshow test, and were compared with the endometriosis fertility index (EFI). Moreover, the association betweenpreoperative SII and change of anti-Müllerian hormone (AMH) were investigated.Results Compared with the non-pregnancy group, the age [(30.3±3.9) vs. (31.8±4.1)] and duration of infertility [2 (1,3) vs. 2(2,4) years] was significantly lower while the preoperative SII [426 (323, 620) vs. 314(248,413)] and AMH [4.0 (2.0, 4.5)μg/L vs. 2.3 (2.0, 4.0)μg/L] was significantly higher in the pregnancy group (P<0.05). Multivariate analysis revealed that the SII of >380 [OR= 5.93, 95% CI:(3.15,11.18)] and AMH of ≥ 2μg/L [OR=2.24,95%CI: (1.15, 4.34)] were independent factors for postoperative pregnancy outcome (P<0.05). A combination of preoperative SII and AMH had a high predictive ability (AUC=0.76) and a good fit (P>0.05), and had a better clinical utility than the EFI. Moreover, compared withthose with lower SII, patients with higher SII had a significantly higher level of postoperative SII (median: 3.7 μg/L vs. 3.2 μg/L) (P< 0.05).Conclusion Preoperative SII is closely associated with the natural pregnancy outcome in infertile patients with OMA, which canassist in the decision-making processes. |
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