| 摘要: |
| 目的 探讨Z-评分（Z评分）在评价盆膈裂孔扩张性能中的价值。方法 选取排除盆腔器官脱垂（POP）的202例女性（对照组），应用三维盆底超声测量其静息期盆膈裂孔参数（盆膈裂孔前后径、左右径及面积）为自变量，张力期盆膈裂孔参数为因变量进行线性回归分析，根据结果确定参数并建立Z评分模型。将259例POP女性（POP组）张力期盆膈裂孔参数导入Z评分模型评价其扩张程度。应用受试者工作特征（ROC）曲线检验Z评分的统计学价值。结果 对照组女性的张力期与静息期盆膈裂孔面积具有较好的相关性（r=0.74），以盆膈裂孔面积为参数建立Z评分模型为：Z评分=（实际观测值-17.37）/3.00，POP组Z评分值大于对照组，且随着POP程度增加而增大，组间比较差异有统计学意义（P＜0.05）。ROC曲线验证Z评分模型对于诊断盆膈裂孔异常扩张具有较高的敏感性和特异性，对于Ⅱ度POP，当Z评分诊断临界值为0.86时，敏感性和特异性分别为0.90、0.80；对于Ⅲ度POP，Z评分诊断临界值为1.83时，敏感性和特异性分别为0.89与0.96。结论 Z评分能科学定量评价盆膈裂孔扩张性，当Z评分≥0.86时，可判定为盆膈裂孔异常扩张。 |
| 关键词: 超声检查，三维 Z评分 盆腔器官脱垂 盆膈裂孔 |
| DOI： |
| 投稿时间：2019-09-23修订日期：2019-12-30 |
| 基金项目:国家自然科学基金面上项目(NO:81571699) |
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| Value of Z-score in evaluating of the distensibility of levator hiatus |
| zhou min zhi,du hai wen,ying tao,shui wen,dou chao ran |
| (Shanghai Jiao Tong University Affiliated Sixth People’s Hospital) |
| Abstract: |
| Objective To explore the value of Z-score in evaluating the distensibility of levator hiatus.Methods A total of 202 women excluding pelvic organ prolapse（POP）were selected as the control group.The parameters of levator hiatus (anterior–posterior diameter, coronal diameter and area) achieved by three-dimensional ultrasound at rest were used as the independent variable and the parameters on Valsalva were used as the dependent variable for linear regression analysis.Z-score model was established according to the parameter determined by regression analysis.The parameters of 259 women with POP（POP group）on Valsalva were imported into the Z-score model to evaluate the distensibility of levator hiatus.ROC curve analysis was used to test the statistical value of Z-score model.Results The regression analysis revealed a good correlation between the area of levator hiatus at rest and on Valsalva（r=0.74）.The z-score model was established with the parameter of levator hiatus area:Z score = (actual observed value -17.37) /3.00.The z-score value of the POP group was larger than that of the control group,and increased with the degree of POP.The difference between groups was statistically significant (P < 0.05).ROC curve analysis confirmed the value of Z-score in detecting abnormal levator hiatus distensibility.For POP grade Ⅱ,z-score value of 0.86 cut-off resulted in sensitivity of 0.90 and specificity of 0.80. For POP grade Ⅲ, z-score value of 1.83 cut-off resulted in sensitivity of 0.89 and specificity of 0.96.Conclusion Z-score can be used to evaluate the distensibility pf levator hiatus scientifically and quantitatively，and when Z-score ≥0.86，it can be diagnosed as abnormal levator hiatus distensibility. |
| Key words: Ultrasonography,three-dimensional Z-score Pelvic organ prolapse Levator hiatus |
