| 摘要: |
| 目的 探讨基于盆底超声参数及基质金属蛋白酶-1(MMP-1)、骨桥蛋白(OPN)、结缔组织生长因子(CTGF)预测初产妇压力性尿失禁(SUI)的列线图模型建立。方法 回顾性分析2021年1月~2023年1月收治的148例初产妇的临床资料,根据产后3个月是否发生SUI分为SUI组(37例)及非SUI组(111例)。采用单因素分析、多因素Logistic回归分析初产妇SUI的影响因素,并建立列线图模型,采用受试者工作特征曲线(ROC曲线)分析该模型的预测价值。结果 多因素Logistic回归分析显示,盆底超声参数[尿道旋转角(URA)、尿道倾斜角(UTA)、膀胱颈移动度(BND)、膀胱尿道后角(PUA)、肛提肛裂孔面积(LHA)]及血清MMP-1、OPN、CTGF等均为初产妇SUI的独立危险因素(P<0.05)；基于以上8个指标构建的列线图模型的AUC为0.841(95% C.I.:0.756~0.926),均高于模型中各单项指标,且该列线图模型拟合程度较好(Hosmer-Lemeshow x2=82.349,P=0.642)。结论 URA、UTA、BND、PUA、LHA、MMP-1、OPN、CTGF等均为初产妇SUI独立预测因素,基于以上8个指标建立的列线图模型对初产妇SUI具有较高预测价值,能为初产妇SUI防治提供理论依据。 |
| 关键词: 盆底超声参数 基质金属蛋白酶-1 骨桥蛋白 结缔组织生长因子 初产妇 压力性尿失禁 列线图模型 |
| DOI： |
| 投稿时间：2023-09-06修订日期：2023-10-13 |
| 基金项目: |
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| A nomogram model was established based on pelvic floor ultrasound parameters, MMP-1, OPN and CTGF to predict stress urinary incontinence in primipara |
| Jiang Yuhua,Liu Chuanjin,Wang Bingzhi,Wang Linna |
| () |
| Abstract: |
| Objective To establish a nomogram model for predicting stress urinary incontinence (SUI) in puerperal women based on pelvic floor ultrasound parameters, matrix metalloproteinase-1 (MMP-1), osteopontin (OPN) and connective tissue growth factor (CTGF).Method The clinical data of 148 primiparas admitted from January 2021 to January 2023 were retrospectively analyzed. According to whether SUI occurred 3 months postpartum, they were divided into SUI group (37 cases) and non-SUI group (111 cases). Unifactor analysis and multiple Logistic regression were used to analyze the influencing factors of SUI in primipara. A nomogram model was constructed, and receiver operating characteristic curve (ROC curve) was used to analyze the predictive value of this model.Result Multivariate Logistic regression analysis showed that Pelvic floor ultrasound parameters [urethral rotation Angle (URA), urethral inclination Angle (UTA), bladder neck mobility (BND), vesicourethral posterior Angle (PUA), anal extraction and anal fissure area (LHA)] and serum MMP-1, OPN and CTGF were independent risk factors for SUI in parturient women (P<0.05). The AUC of the column-line diagram model constructed based on the above eight indexes was 0.920, and the sensitivity and specificity were 100.0% and 92.0%, which were all higher than each single index in the model, and the column-line diagram model was well fitted (Hosmer-Lemeshow x2=82.349,P=0.642).Conclusion URA, UTA, BND, PUA, LHA, MMP-1, OPN, and CTGF are all independent predictors of SUI in primipara. The nomogram model established based on the above 8 indicators has high predictive value for SUI in primipara, and can provide theoretical basis for the prevention and treatment of SUI in primipara. |
| Key words: Pelvic floor ultrasonic parameters Matrix metalloproteinase-1 Osteopontin Connective tissue growth factor Primipara Stress urinary incontinence Nomogram model |
