摘要
目的分析复发性流产(recurrent spontaneous abortion,RSA)患者发生早期自然流产的危险因素,并建立基于危险因素的列线图模型。方法采用回顾性分析方法,收集2022年7月至2023年7月收治的150例RSA患者临床资料,根据是否发生早期自然流产分为早期流产组46例和非流产组104例。比较2组患者临床资料的差异,采用多因素Logistic回归分析早期自然流产的危险因素和建立列线图预测模型,并对模型预测性能进行评估。结果多因素Logistic回归结果显示,内膜因素(OR=0.128,95%CI=0.030~0.538)、解剖因素(OR=0.243,95%CI=0.074~0.796)、抗凝治疗(OR=0.127,95%CI=0.030~0.538)、免疫治疗(OR=0.932,95%CI=0.868~1.000)、凝血酶原时间(OR=0.251,95%CI=0.105~0.600)、凝血酶时间(OR=1.171,95%CI=1.033~1.328)、空腹血糖(OR=0.453,95%CI=0.229~0.897)是RSA患者发生早期自然流产的危险因素(P<0.05)。列线图预测早期自然流产的曲线下面积为0.907(95%CI:0.849~0.949),敏感性为80.43%,特异性为87.50%,约登指数为0.679。结论内膜因素、解剖因素、抗凝治疗、免疫治疗、凝血酶原时间、凝血酶时间、空腹血糖是RSA患者发生早期自然流产的危险因素,基于危险因素建立的列线图模型对早期自然流产具有一定预测价值,方便医护人员采取医疗干预措施。
Objective To explore the risk factors for an early spontaneous abortion in recurrent spontaneous abortion(RSA)patients and to establish a nomogram based on the risk factors.Methods By a retrospective analysis method,clinical data of a total of 150 RSA patients from July 2022 to July 2023 were collected.They were divided to abortion group(46 cases)and non-abortion group(104 cases)according to the onset of an early spontaneous abortion.The difference of clinical data between two groups was compared.Risk factors for early spontaneous abortion were analyzed by multivariate Logistic regression.A nomogram was established based on the risk factors,and the predictive performance of the model was assessed.Results Multivariate Logistic regression demonstrated that endometrial factor(OR=0.128,95%CI=0.030-0.538),anatomical factor(OR=0.243,95%CI=0.074-0.796),anticoagulation therapy(OR=0.127,95%CI=0.030-0.538),immunotherapy(OR=0.932,95%CI=0.868-1.000),prothrombin time(OR=0.251,95%CI=0.105-0.600),thrombin time(OR=1.171,95%CI=1.033-1.328)and fasting blood glucose(OR=0.453,95%CI=0.229-0.897)were independent risk factors for an early spontaneous abortion(all P<0.05).The area under the curve(AUC)of the nomogram in predicting an early spontaneous abortion was 0.907(95%CI=0.849-0.949),with the sensitivity of 80.43%,specificity of 87.50%,and Youden index of 0.679.Conclusion Endometrial factor,anatomical factor,anticoagulation therapy,immunotherapy,prothrombin time,thrombin time and fasting blood glucose are independent risk factors for predicting an early spontaneous abortion of RSA patients.A nomogram created based on the risk factors-has a certain predictive value for early spontaneous abortion,which can facilitates medical staff to take active medical interventions.
作者
徐丽华
刘晓芳
雷鸣
XU Lihua;LIU Xiaofang;LEI Ming(Department of Reproductive Endocrinology,Yinchuan Guolong Orthopaedic Hospital,Ningxia,Yinchuan 750000,China;不详)
出处
《河北医药》
2025年第1期144-148,共5页
Hebei Medical Journal
基金
宁夏回族自治区科技惠民专项项目(编号:2022CMG3047)。
关键词
复发性流产
早期自然流产
危险因素分析
列线图模型
预测
recurrent spontaneous abortion
early spontaneous abortion
risk factor analysis
nomogram model
prediction
