| 摘要: |
| 目的 分析产后早期压力性尿失禁(SUI)患者盆底结构的变化,建立基于判别分析的产后早期SUI超声诊断模型。方法 选取2017年8月-2019年9月华北理工大学附属医院门诊行产后早期常规体检的女性115例,随机分为实验组即训练样本98例、检验组即验证样本17例,其中实验组分为有SUI组52例,无SUI组46例,对所有受检者行盆底超声检查,记录：HBL、BND、URA、PVUA1、PVUA2,分析比较后,利用Fisher 逐步判别分析法建立诊断模型,并对诊断模型进行验证,同时采用ROC曲线进行评价。结果 (1)有SUI组HBL、BND、URA、PVUA1、PVUA2较无SUI组明显增加,差异有统计学意义(P＜0.05),表明产后早期有SUI女性膀胱颈的位置更靠下方,且在张力状态下的膀胱颈移动度及旋转度更大。(2)SUI诊断模型：无SUI组：Y0=-108.764+2.223X2+1.187X3+1.404X5；有SUI组：Y1=-144.728+4.145 X2+1.879 X3 +1.499X5(其中Y0为无SUI 组,Y1为有SUI组；X2为BND、X3为URA、X5为PVUA2)。(3)通过实验组进行自身检验及交叉验证所得到的准确率分别为94.9%、93.9%,通过检验组验证,所得诊断准确率为82.3%,说明该模型的诊断效果较为理想；采用ROC曲线进行评价,得到曲线下面积为0.939,进一步证明了该模型的诊断价值较高。结论 通过Fisher判别分析综合盆底超声建立的多变量联合诊断模型可以客观反映产后早期SUI患者盆底功能的变化,为临床早期诊断、早期干预提供依据。 |
| 关键词: 判别分析 产后早期 压力性尿失禁 超声诊断模型 |
| DOI： |
| 投稿时间：2020-03-11修订日期：2020-04-01 |
| 基金项目:河北省省属高校基本科研业务费项目(JQN2019014)作者单位：063000,河北唐山市,华北理工大学附属医院超声科通讯作者：马琳,Email：920983050@qq.com |
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| Establishment of Ultrasound Diagnosis Model of Stress Urinary Incontinence in Early Stage of Postpartum Based on Discriminant Analysis |
| LI Ning,KAN Yan-min,LI Xiao-song,WANG Yi-hua,LIU Yang,GUO Yan-juan,MA Lin |
| () |
| Abstract: |
| ABSTRACT Objective To analyze the changes of pelvic floor structure in patients with stress urinary incontinence (SUI) in early stage of pregnancy. Establish the ultrasound diagnosis model of SUI based on discriminant analysis.Methods Select 115 female cases who had been given physical examination in early stage of postpartum at Affiliated Hospital of North China University of Technology from August 2017 to September 2019.They were randomly divided into the experimental group(98 training samples) and the test group (12 validation samples).The experimental group consisted of 52 SUI cases and 42 non-SUI cases. Pelvic floor ultrasound was examined on all of the cases and the value of HBL,BND,URA,PVUA1,PVUA were recorded. Analysis and compare the according data, use Fisher stepwise discriminant analysis method to establish the diagnosis model, validate the according model and use ROC curve to evaluate the model.Results (1)Value of HBL,BND,URA,PVUA1,PVUA2 in the SUI group were significantly higher than those in the non-SUI group (P< 0.05), the difference has statistic significance.It indicated that women with SUI in the early postpartum period have a lower bladder neck position.The mobility and rotation of bladder neck in tension state are greater.(2)Diagnostic model of SUI: group without SUI :Y0=-108.764+2.223X2+1.187X3+1.404X5;group with SUI:Y1=-144.728+4.145 X2+1.879 X3 +1.499X5.(Y0 represents the group without SUI, Y1 represents the group with SUI; X2 represents BND, X3 represents URA and X5 represents PVUA2). (3) The results was obtained by self-test and cross-validation in the experimental group with an accuracy of 94.9%and 93.9%.The results were checked in the test group with an accuracy of 82.3%.It shows that the diagnostic effect of the model is ideal. Throw evaluating ROC curve we get that the area in the curve is 0.939,it is further proved that the diagnosis value of the model is higher. Conclusion The multi-variable combined diagnostic model established by Fisher discriminat analysis pelvic floor ultrasound can objectively reflect the changes of pelvic floor function of SUI patients in the early stage of postpartum which provide evidence for early clinical diagnosis and intervention. |
| Key words: Discriminant analysis Early stage of postpartum Stress urinary incontinence Ultrasound diagnosis model |
