子宫动脉血流动力学与血清CA125、NLR、INHB联合诊断卵巢子宫内膜异位囊肿及介入超声硬化术治疗后复发情况分析OA
Combined Diagnosis of Ovarian Endometriosis Cyst by Uterine Artery Hemo-dynamics and Serum CA125,NLR,INHB and Analysis of Recurrence after Interventional Ultrasound Sclerotherapy
目的:探讨子宫动脉血流动力学与血清糖类抗原125(CA125)、中性粒细胞与淋巴细胞比值(NLR)、抑制素B(INHB)联合诊断卵巢子宫内膜异位囊肿(OEM)及介入超声硬化术治疗后复发情况.方法:本研究选取2020年3月至2021年3月我院收治的132例卵巢子宫内膜异位囊肿患者作为OEM组,50例卵巢单纯囊肿患者作为对照组,通过超声检测OEM患者无囊肿侧子宫与囊肿侧子宫动脉血流动力学指标[阻力指数(RI)、搏动指数(PI)、动脉收缩期峰值流速/舒张末期血流速度值(S/D)],通过血液检测获取OEM组与对照组血清CA125、NLR、INHB水平,ROC曲线分析RI、PI、S/D、CA125、NLR、INHB联合诊断卵巢子宫内膜异位囊肿的价值.随访 2年,统计OEM介入超声硬化术治疗后复发情况,比较未复发组与复发组的临床资料及RI、PI、S/D、CA125、NLR、INHB值,Logistic回归模型分析OEM介入超声硬化术治疗后复发的影响因素.结果:与无囊肿侧子宫比较,囊肿侧子宫动脉RI、PI、S/D显著升高(P<0.05),表明囊肿侧子宫动脉血流动力学出现了明显异常;与对照组比较,OEM组CA125、NLR水平显著升高(P<0.05),INHB水平显著降低(P<0.05);绘制ROC曲线发现,以0.93、2.34、6.34、45.89、1.76、25.46为截断值时,RI、PI、S/D、CA125、NLR、INHB联合诊断卵巢子宫内膜异位囊肿的效能最高,显著优于各项指标单独检测(P<0.05);随访2年,132例OEM患者介入超声硬化术治疗后复发26例,复发率为 19.70%;两组囊肿直径、生育史、囊肿位置、术后应用GnRH-α占比差异无统计学意义(P>0.05);与未复发组比较,复发组年龄≥35岁占比、囊壁厚度≥0.3 cm占比、R-AFS分期Ⅲ～Ⅳ期占比、RI、PI、S/D、CA125、NLR明显升高(P<0.05),INHB明显降低(P<0.05);Logistic回归模型显示,年龄≥35岁、囊壁厚度≥0.3 cm、R-AFS分期Ⅲ～Ⅳ期及RI、PI、S/D、CA125、NLR值升高是OEM介入超声硬化术治疗后复发的危险因素(P<0.05),INHB为其保护因素(P<0.05).结论:子宫动脉血流动力学联合血清CA125、NLR、INHB诊断卵巢子宫内膜异位囊肿具有较高的临床应用价值,并与介入超声硬化术治疗后复发相关,本研究的结果为卵巢子宫内膜异位囊肿的诊断和治疗提供了新的思路和方法.
Objective:To investigate the diagnosis of ovarian endometrioma(OEM)by uterine artery hemodynamics combined with serum carbohydrate antigen 125(CA125),neutrophil lymphocyte ratio(NLR),inhibin B(INHB)and the recurrence after interventional ultrasound sclerotherapy.Methods:132 patients with OEM admitted to our hospital from March 2020 to March 2021 were selected as the OEM group,and 50 patients with ovarian simple cysts were selected as the control group.The hemodynamic indicators of the non cyst side uterus and cyst side uterus arteries in OEM patients were analyzed,including resistance index(RI),pulsation index(PI),peak systolic velocity/end diastolic velocity(S/D).The serum levels of CA125,NLR,and INHB were compared between the OEM group and the control group,and the ROC curve was analyzed.The value of combining PI,S/D,CA125,NLR,and INHB in the diagnosis of OEM.Follow up for 2 years,analyze the recurrence rate after OEM interventional ultrasound sclerotherapy treatment,compare the clinical data and RI,PI,S/D,CA125,NLR,INHB values between the non recurrence group and the recurrence group,and analyze the influencing factors of recurrence after OEM interventional ultrasound sclerotherapy treatment using a logistic regression model.Results:Compared with the non cyst side uterus,the RI,PI,and S/D of the cyst side uterine artery were significantly increased(P<0.05).Compared with the control group,the levels of CA125 and NLR in the OEM group were significantly increased(P<0.05),while the levels of INHB were significantly reduced(P<0.05).Drawing the ROC curve,it was found that when the cutoff values were 0.93,2.34,6.34,45.89,1.76,and 25.46,the combination of RI,PI,S/D,CA125,NLR,and INHB had the highest efficacy in diagnosing OEM,significantly superior to individual detection of various indicators(P<0.05);Following up for 2 years,26 out of 132 OEM patients experienced recurrence after interventional ultrasound sclerotherapy,with a recurrence rate of 19.70%.There were no significant differences between the two groups in cyst diameter,fertility history,cyst location,or the proportion of patients receiving post-operative GnRH-α therapy(P>0.05).Compared with the non recurrent group,the proportion of patients with age≥35 years old,cyst wall thickness≥0.3 cm,R-AFS stage Ⅲ～Ⅳ,RI,PI,S/D,CA125,NLR in the recurrent group were significantly increased(P<0.05),and INHB was significantly reduced(P<0.05).The Logistic regression model showed that age≥35 years old,cyst wall thickness≥0.3 cm,R-AFS stage Ⅲ～Ⅳ,and elevated RI,PI,S/D,CA125,and NLR values were risk factors for recurrence after OEM interventional ultrasound sclerotherapy(P<0.05),with INHB as the protective factor(P<0.05).Conclusion:The combination of uterine artery hemodynamics and serum CA125,NLR,and INHB in the diagnosis of OEM has certain clinical application value and is associated with recurrence after interventional ultrasound sclerotherapy.
姚亚丽;高崇于;方彦鹏;吴贤;文榆林
贵州中医药大学第二附属医院 超声科,贵州 550000贵州中医药大学第二附属医院 超声科,贵州 550000贵州中医药大学第二附属医院 超声科,贵州 550000贵州中医药大学第二附属医院 超声科,贵州 550000贵州中医药大学第二附属医院 超声科,贵州 550000
医药卫生
子宫动脉血流动力学糖类抗原125中性粒细胞与淋巴细胞比值抑制素B卵巢子宫内膜异位囊肿
uterine artery hemodynamicscarbohydrate antigen 125neutrophil lymphocyte ratioinhibin Bovarian endometrioma
《影像科学与光化学》 2026 (1)
14-20,27,8
2022年贵州省卫生健康委员会科学技术基金项目(gzwkj2022-181).
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