子宮內(nèi)膜異位癥早期綜合評(píng)分臨床診斷模型研究
發(fā)布時(shí)間：2019-05-10 20:32
【摘要】：背景子宮內(nèi)膜異位癥(EMs)嚴(yán)重影響患者生活質(zhì)量,探討EMs早期安全有效的診斷方法,對(duì)提高其臨床診斷正確率、避免腹腔鏡手術(shù)有重要意義。目的以EMs患者的痛經(jīng)、慢性盆腔痛、婦科檢查結(jié)果、超聲檢查結(jié)果、血清上皮性卵巢癌抗原(CA125)檢測(cè)結(jié)果、子宮內(nèi)膜組織細(xì)胞色素芳香化酶(P450arom)檢測(cè)結(jié)果為變量,構(gòu)建EMs早期綜合評(píng)分臨床診斷模型,并探討該模型對(duì)EMs的早期診斷價(jià)值,以期探尋安全有效經(jīng)濟(jì)實(shí)用的診斷方法,提高EMs的早期診斷正確率,降低腹腔鏡手術(shù)的可能性。方法選擇2015年1月—2016年10月在麗水市中心醫(yī)院婦產(chǎn)科住院的符合納入標(biāo)準(zhǔn)的臨床診斷為盆腔EMs的擬行腹腔鏡手術(shù)患者150例為研究對(duì)象。采用單純隨機(jī)抽樣法將患者分為建模組(100例)和驗(yàn)證組(50例)。收集患者一般資料,包括病史、主要癥狀、婦科檢查結(jié)果;記錄患者超聲檢查、血清CA125檢測(cè)、子宮內(nèi)膜組織P450arom檢測(cè)結(jié)果。以腹腔鏡手術(shù)結(jié)合組織病理學(xué)診斷結(jié)果為金標(biāo)準(zhǔn)。利用多因素Logistic回歸分析構(gòu)建EMs早期綜合評(píng)分臨床診斷模型,繪制其診斷EMs的受試者工作特征(ROC)曲線,計(jì)算ROC曲線下面積(AUC)、靈敏度、特異度。結(jié)果建模組中,金標(biāo)準(zhǔn)診斷陽(yáng)性78例,陰性22例;驗(yàn)證組中,金標(biāo)準(zhǔn)診斷陽(yáng)性24例,陰性26例。建模組中,超聲檢查陽(yáng)性率為91.0%(91/100),血清CA125檢測(cè)陽(yáng)性率為64.0%(64/100),子宮內(nèi)膜組織P450arom檢測(cè)陽(yáng)性率為76.0%(76/100)。采用多因素逐步Logistic回歸分析構(gòu)建EMs早期綜合評(píng)分臨床診斷模型:y=-10.77+4.96×痛經(jīng)+1.88×慢性盆腔痛+3.02×婦科檢查體征陽(yáng)性+3.68×超聲檢查陽(yáng)性+1.41×血清CA125檢測(cè)陽(yáng)性+4.56×子宮內(nèi)膜組織P450arom檢測(cè)陽(yáng)性。血清CA125檢測(cè)診斷建模組EMs的AUC為0.735,95%CI(0.614,0.857),靈敏度為74.4%,特異度為72.7%;子宮內(nèi)膜組織P450arom檢測(cè)診斷建模組EMs的AUC為0.841,95%CI(0.732,0.951),靈敏度為91.0%,特異度為77.3%;EMs早期綜合評(píng)分臨床診斷模型診斷建模組EMs的AUC為0.969,95%CI(0.936,1.000),診斷截?cái)嘀禐?.833,靈敏度為93.6%,特異度為86.4%。將EMs早期綜合評(píng)分臨床診斷模型用于驗(yàn)證組,AUC為0.881,95%CI(0.777,0.985),靈敏度為91.7%,特異度為84.6%。結(jié)論本研究所建立的EMs早期綜合評(píng)分臨床診斷模型,一定程度上提高了EMs的早期診斷正確率,作為一種微創(chuàng)性檢查手段,該模型可應(yīng)用于臨床EMs的早期診斷。
[Abstract]:Background Endometriosis (EMs) seriously affects the quality of life of patients. It is of great significance to explore the early safe and effective diagnostic methods of EMs in order to improve the accuracy of clinical diagnosis and avoid laparoscopic surgery. Objective to study the results of dysmenorrhea, chronic pelvic pain, gynecological examination, ultrasound, serum epithelial ovarian cancer antigen (CA125) and endometrial tissue cytochrome aromatase (P450arom) in patients with EMs. To construct the clinical diagnosis model of EMs early comprehensive score, and to explore the value of this model in the early diagnosis of EMs, in order to explore the safety and effectiveness of the model. An economical and practical diagnostic method can improve the accuracy of early diagnosis of EMs and reduce the possibility of laparoscopic surgery. Methods from January 2015 to October 2016, 150 patients who met the inclusion criteria in obstetrics and gynaecology of Lishui Central Hospital were enrolled in this study. The patients were divided into model group (100 cases) and verification group (50 cases) by simple random sampling. The general data of the patients were collected, including medical history, main symptoms, gynecological examination results, ultrasonic examination, serum CA125 test, endometrial tissue P450arom test results. The results of laparoscopic surgery combined with histopathological diagnosis were taken as the gold standard. The clinical diagnosis model of EMs early comprehensive score was constructed by multivariate Logistic regression analysis. The (ROC) curve of the subjects' working characteristics in the diagnosis of EMs was drawn, and the sensitivity and specificity of area (AUC), under ROC curve were calculated. Results in the model group, 78 cases were positive and 22 cases were negative by gold standard, and 24 cases were positive and 26 cases were negative by gold standard in the verification group. In the model group, the positive rate of ultrasound was 91.0% (91 鈮，
本文編號(hào)：2473966
[Abstract]:Background Endometriosis (EMs) seriously affects the quality of life of patients. It is of great significance to explore the early safe and effective diagnostic methods of EMs in order to improve the accuracy of clinical diagnosis and avoid laparoscopic surgery. Objective to study the results of dysmenorrhea, chronic pelvic pain, gynecological examination, ultrasound, serum epithelial ovarian cancer antigen (CA125) and endometrial tissue cytochrome aromatase (P450arom) in patients with EMs. To construct the clinical diagnosis model of EMs early comprehensive score, and to explore the value of this model in the early diagnosis of EMs, in order to explore the safety and effectiveness of the model. An economical and practical diagnostic method can improve the accuracy of early diagnosis of EMs and reduce the possibility of laparoscopic surgery. Methods from January 2015 to October 2016, 150 patients who met the inclusion criteria in obstetrics and gynaecology of Lishui Central Hospital were enrolled in this study. The patients were divided into model group (100 cases) and verification group (50 cases) by simple random sampling. The general data of the patients were collected, including medical history, main symptoms, gynecological examination results, ultrasonic examination, serum CA125 test, endometrial tissue P450arom test results. The results of laparoscopic surgery combined with histopathological diagnosis were taken as the gold standard. The clinical diagnosis model of EMs early comprehensive score was constructed by multivariate Logistic regression analysis. The (ROC) curve of the subjects' working characteristics in the diagnosis of EMs was drawn, and the sensitivity and specificity of area (AUC), under ROC curve were calculated. Results in the model group, 78 cases were positive and 22 cases were negative by gold standard, and 24 cases were positive and 26 cases were negative by gold standard in the verification group. In the model group, the positive rate of ultrasound was 91.0% (91 鈮，
本文編號(hào)：2473966
本文鏈接：http://sikaile.net/yixuelunwen/fuchankeerkelunwen/2473966.html
最近更新
教材專著
