摘要
目的:探讨盆底三维超声参数联合血清基质金属蛋白酶-1(MMP-1)、骨桥蛋白(OPN)、结缔组织生长因子(CTGF)水平对压力性尿失禁疾病严重程度的预测价值。方法:选择280例压力性尿失禁患者作为观察组,另选同期的100例健康体检者作为对照组。所有受试者均在Valsalve动作下检测盆底三维超声参数、血清MMP-1、OPN、CTGF表达水平,分析不同严重程度的压力性尿失禁患者盆底三维超声参数、血清MMP-1、OPN、CTGF表达水平的差异性,使用多因素Logistic回归分析和受试者工作特征曲线(ROC)下面积(AUC)评价盆底三维超声参数、血清MMP-1、OPN、CTGF与压力性尿失禁疾病的关系。结果:观察组膀胱颈移动度、尿道倾斜角、尿道旋转角、膀胱尿道后角和裂孔面积均大于对照组(均P<0.05);观察组血清MMP-1、OPN、CTGF表达水平均高于对照组(均P<0.05);随着压力性尿失禁疾病严重程度的增大,膀胱颈移动度、尿道倾斜角、尿道旋转角、膀胱尿道后角和裂孔面积均随之增大,血清MMP-1、OPN、CTGF表达水平均随之升高(均P<0.05);经多因素Logistic回归分析,膀胱颈移动度、裂孔面积、血清MMP-1、OPN、CTGF均是压力性尿失禁疾病的独立预测因素(均P<0.05);经ROC曲线分析,膀胱颈移动度、裂孔面积、血清MMP-1、OPN联合CTGF预测压力性尿失禁疾病的AUC为0.915。结论:盆底三维超声参数、血清MMP-1、OPN、CTGF与压力性尿失禁疾病严重程度密切相关,其中膀胱颈移动度、裂孔面积、血清MMP-1、OPN联合CTGF预测压力性尿失禁疾病严重程度的效能较高。
Objective:To analyze the predictive value of three-dimensional pelvic floor ultrasound parameters combined with serum matrix metalloproteinase-1(MMP-1),osteopontin(OPN)and connective tissue growth factor(CTGF)in the severity of stress urinary incontinence.Methods:A total of 280 patients with stress urinary incontinence were selected as the observation group,and 100 healthy people in the same period were selected as the control group.Pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN and CTGF expression levels were detected in all subjects under Valsalve action,and the differences of pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN and CTGF expression levels in patients with stress urinary incontinence of different severity were analyzed.Multivariate Logistic regression analysis and the area under ROC curve(AUC)were used to evaluate the relationship between pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN,CTGF and stress urinary incontinence.Results:The bladder neck mobility,urethral inclination angle,urethral rotation angle,posterior urethral angle and hiatus area in the observation group were higher than those in the control group(all P<0.05).The expression levels of MMP-1,OPN and CTGF in the observation group were higher than those in the control group(all P<0.05).With the increase of the severity of stress urinary incontinence,the bladder neck mobility,urethral inclination angle,urethral rotation angle,posterior urethral angle and hiatal area were increased,and the expression levels of MMP-1,OPN and CTGF in serum were increased(all P<0.05).Multivariate Logistic regression analysis showed that bladder neck mobility,hiatal area,serum MMP-1,OPN and CTGF were independent predictors of stress urinary incontinence(all P<0.05).ROC curve analysis showed that the AUC of bladder neck mobility,hiatal area,serum MMP-1,OPN combined with CTGF in predicting stress urinary incontinence was 0.915.Conclusion:Pelvic floor three-dimensional ultrasound parameters,serum MMP-1,OPN and CTGF are closely related to the severity of stress urinary incontinence.Bladder neck mobility,hiatal area,serum MMP-1 and OPN combined with CTGF have a high efficacy in predicting stress urinary incontinence.
作者
高鑫
贾红娥
李倩
康旺旺
GAO Xin;JIA Hong’e;LI Qian;KANG Wangwang(Deparment of UItrasonic Diagnosis,Yulin No.2 Hospital,Yulin 719000,China)
出处
《陕西医学杂志》
CAS
2023年第2期149-153,共5页
Shaanxi Medical Journal
基金
陕西省榆林市科技计划项目(YF-2021-61)。
关键词
压力性尿失禁
盆底三维超声参数
基质金属蛋白酶-1
骨桥蛋白
结缔组织生长因子
疾病严重程度
Stress urinary incontinence
Three-dimensional ultrasound parameters of pelvic floor
Matrix metalloproteinase-1
Osteopontin
Connective tissue growth factor
Disease severity
