摘要
目的:分析血清基质金属蛋白酶9(MMP9)、Toll样受体4(TLR4)对子宫内膜息肉(EP)患者术后继发宫腔粘连(IUA)风险的预测价值。方法:回顾性分析黄河三门峡医院2021年6月—2023年12月收治的118例EP患者的病历资料,所有患者均实施息肉切除术治疗,术后随访1年,依据是否发生IUA分为IUA组(n=18)和非IUA组(n=100),采用多因素Logistic回归方程分析影响EP患者术后继发IUA的影响因素,绘制ROC曲线分析血清MMP9、TLR4对EP患者术后继发IUA的预测价值。结果:单因素分析显示,2组年龄、BMI、病程及合并高血压患者比例比较差异无统计学意义(P>0.05);IUA组孕次、手术时间、术中出血量及合并糖尿病、合并盆腔炎史、多发息肉、有刮宫史、有剖宫产史、合并内膜增生、有宫内节育器患者比例,以及血清TLR4水平高于非IUA组,血清MMP9水平低于非IUA组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,孕次、合并糖尿病、多发息肉、有刮宫史、有宫内节育器、手术时间及血清MMP9、TLR4水平为影响EP患者术后继发IUA的影响因素。血清MMP9、TLR4水平预测EP患者术后继发IUA的AUC为0.867、0.866;二者联合预测的AUC为0.932,灵敏度为90.34%、特异度为81.28%。结论:MMP9低表达,TLR4过表达会增加EP患者术后继发IUA的风险,联合检测二者水平对EP患者术后继发IUA具有一定预测价值。
Objective:To analyze the association between MMP9,TLR4,and the risk of intrauterine adhesions(IUA)in patients with endometrial polyps(EP)after surgery.Methods:A retrospective analysis was conducted on the medical data of 118 patients with EP in a hospital from June 2021 to December 2023.All the patients underwent polypectomy and were followed up for one year after surgery.Based on whether IUA occurred after surgery,they were divided into an IUA group(18 cases)and a non-IUA group(100 cases).The risk factors for postoperative intrauterine adhesions in patients with EP were summarized,and the predictive value of MMP9 and TLR4 for postoperative IUA in patients was analyzed.Results:The univariate analysis showed that the proportion of patients with pregnancy times,operation time,intraoperative bleeding,diabetes,pelvic inflammation,multiple polyps,curettage,cesarean section,endometrial hyperplasia,intrauterine device,and serum TLR4 levels in the IUA group were higher than those in the non-IUA group,while MMP9 level was lower than that of the non-IUA group(P<0.05).Logistic regression analysis showed that pregnancy times,diabetes,multiple polyps,curettage history,intrauterine device,operation time,MMP9,TLR4 were risk factors for secondary IUA in EP patients after surgery.The sensitivity and specificity of the combined detection of MMP9 and TLR4 for predicting secondary IUA after EP surgery were 90.34%and 81.28%,respectively,both higher than the detection of MMP9 alone(82.41%,78.33%)and TLR4 alone(81.45%,72.36%)(AUC=0.932,0.867,0.866).Conclusion:Low expression of MMP9 and overexpression of TLR4 increase the risk of postoperative IUA in EP patients.Combined detection of MMP9 and TLR4 can provide some reference for predicting polyps.
作者
谭慧
马良
TAN Hui;MA Liang(Department of Gynecology,Yellow River Sanmenxia Hospital,Sanmenxia,Henan 472000,China)
出处
《淮海医药》
2025年第5期466-469,共4页
Journal of Huaihai Medicine
基金
河南省医学科技攻关项目(LHGJ2021013209316)。
