摘要
目的 探究子宫内膜异位症生育指数(EFI)联合血清抗米勒管激素(AMH)对子宫内膜异位症(EMT)患者自然妊娠结局的预测价值。方法 选择行腹腔镜手术治疗的113例子宫内膜异位症患者作为研究对象,均于术前及术后对其EFI、AMH进行检测,然后随访2年,根据自然妊娠结局将其分为自然妊娠成功组(70例)和自然妊娠失败组(43例)。统计113例患者术后EFI评分及术前、术后AMH水平;比较自然妊娠成功组和自然妊娠失败组的一般资料及术后EFI评分、AMH水平;分析EFI、AMH单独检测及联合检测对子宫内膜异位症患者自然妊娠结局的预测价值。结果 113例子宫内膜异位症患者术后的EFI评分为(5.63±1.38)分;患者术前AMH水平为(2.30±0.64)ng/ml,术后为(4.16±0.59)ng/ml,术后的AMH水平高于术前(P<0.05)。术后随访2年,其中有70例患者自然妊娠成功(自然妊娠成功组),成功率为61.95%;43例自然妊娠失败(自然妊娠失败组),失败率为38.05%。自然妊娠成功组和自然妊娠失败组的年龄、不孕病程、体质量指数、不孕类型比较,无明显差异(P>0.05)。术后,自然妊娠成功组的EFI评分(6.03±0.72)分、AMH水平(4.32±0.55)ng/ml均比自然妊娠失败组的(4.33±1.26)分、(3.89±0.87)ng/ml高(P<0.05)。联合检测的曲线下面积(AUC)为0.902、特异度为97.33%,均比EFI、AMH单独检测的0.816、90.54%及0.802、93.45%高。结论 子宫内膜异位症患者经腹腔镜手术治疗后EFI、AMH水平较高者的自然妊娠成功率更高, EFI、AMH可对自然妊娠结局进行预测,两者联合的预测价值更高。
Objective To explore the predictive value of endometriosis fertility index(EFI)combined with serum anti-Müllerian hormone(AMH)for natural pregnancy outcome in patients with endometriosis(EMT).Methods 113 patients with endometriosis who underwent laparoscopic surgery were selected for the study,and all of them were tested for EFI and AMH before and after surgery,and then followed up for 2 years,and they were divided into successful natural pregnancy group(70 cases)and failed natural pregnancy group(43 cases)according to their natural pregnancy outcome.Postoperative EFI score and preoperative and postoperative AMH levels were counted in 113 patients.The general data and postoperative EFI score and AMH levels were compared between the successful natural pregnancy group and the failed natural pregnancy group;the predictive value of EFI and AMH alone and in combination on the outcome of natural pregnancy in patients with endometriosis was analyzed.Results The postoperative EFI score of 113 patients with endometriosis was(5.63±1.38)points;the preoperative AMH level was(2.30±0.64)ng/ml,and the postoperative level was(4.16±0.59)ng/ml,and the level of AMH postoperatively was higher than that preoperatively(P<0.05).After 2 years of follow-up,70 patients had successful natural pregnancies (natural pregnancy success group), with a success rate of 61.95%, and 43 had failed natural pregnancies (failed natural pregnancy group), with a failure rate of 38.05%. There was no significant difference in age, course of infertility, body mass index, and type of infertility between the two groups (P>0.05). Postoperatively, the successful natural pregnancy group had EFI score of (6.03±0.72) points and AMH level of (4.32±0.55) ng/ml, which were higher than (4.33±1.26) points and (3.89±0.87) ng/ml in failed natural pregnancy group (P<0.05). The area under the curve (AUC) of the combined test was 0.902 and the specificity was 97.33%, which were higher than EFI and AMH test alone (0.816, 90.54% and 0.802, 93.45%). Conclusion After laparoscopic surgery for endometriosis patients, the success rate of natural pregnancy is higher in those with higher EFI and AMH levels. EFI and AMH can predict the outcome of natural pregnancy, and the predictive value of the combination of both is higher.
作者
赵颖
张杰
金秋利
ZHAO Ying;ZHANG Jie;JIN Qiu-li(Department of Gynecology,Shanxian County Central Hospital,Heze 274300,China)
出处
《中国实用医药》
2024年第11期90-93,共4页
China Practical Medicine
