子宫内膜异位症患者血清中Gal-1和CRH水平变化及临床意义

doi:10.11958/20220180

摘要/Abstract

摘要：

目的探究子宫内膜异位症（EMS）患者血清中半乳糖凝集素-1（Gal-1）和促肾上腺皮质激素释放激素（CRH）水平及临床意义。方法选取93例EMS患者作为EMS组,同时选取90例相同年龄层的健康女性作为对照组。比较2组间血清Gal-1和CRH水平差异。Spearman法分析血清Gal-1和CRH水平与修订的美国生殖协会分期标准（r-AFS）分期的相关性。采用受试者工作特征（ROC）曲线评估血清Gal-1和CRH水平对EMS患者发生不孕的诊断价值。结果 EMS组患者血清中Gal-1和CRH水平较对照组升高（均P<0.05）。二元Logistic回归分析显示,较高水平Gal-1和CRH是影响EMS的独立危险因素（均P<0.05）。随着r-AFS分期的进展,血清中Gal-1和CRH水平逐渐升高（均P<0.05）。血清中Gal-1、CRH水平与r-AFS分期均呈正相关（均P<0.05）。与EMS无不孕症患者相比,EMS合并不孕症患者血清中Gal-1和CRH水平升高（均P<0.05）。ROC曲线显示,Gal-1与CRH联合检测诊断EMS患者出现不孕症的AUC及95%CI[0.836（0.753~0.919）]明显高于单一Gal-1[0.767（0.673~0.862）]或CRH[0.753（0.652~0.854）],联合检测的敏感度和特异度分别为82.22%和79.17%。结论 EMS患者血清中Gal-1和CRH水平升高,两指标联合检测对EMS患者是否出现不孕症具有良好的诊断效能,有利于临床早期针对性治疗。

关键词: 子宫内膜异位症, 半乳糖凝集素1, 促肾上腺皮质素释放激素, 不孕症

Abstract:

Objective To investigate the serum levels and their clinical significance of galectin-1 (Gal-1) and corticotropin releasing hormone (CRH) in patients with endometriosis (EMS). Methods Ninety-three EMS patients were selected as the EMS group. At the same time, 90 healthy females of the same age for hospital examination were selected as the control group. The serum levels of Gal-1 and CRH were compared between the two groups. The correlation between the serum levels of Gal-1 and CRH and r-AFS stage was analyzed by Spearman correlation analysis. ROC curve was used to evaluate the diagnostic value of serum Gal-1 and CRH levels for infertility in EMS patients. Results The serum levels of Gal-1 and CRH were significantly higher in the EMS group than those in the control group (P<0.05). Binary Logistic regression analysis showed that higher levels of Gal-1 and CRH were independent risk factors affecting the occurrence of EMS (P<0.05). With the development of r-AFS stage, the serum levels of Gal-1 and CRH gradually increased (P<0.05). The serum levels of Gal-1 and CRH were positively correlated with r-AFS stage (P<0.05). Compared with EMS patients without infertility, serum Gal-1 and CRH levels were increased in EMS patients with infertility (P<0.05). ROC curve showed that the AUC value of Gal-1 combined with CRH was significantly higher [0.836 (0.753-0.919)] than that of single Gal-1 [0.767 (0.673-0.862)] or CRH [0.753 (0.652-0.854)], and its sensitivity and specificity were 82.22% and 79.17%, respectively. Conclusion The serum levels of Gal-1 and CRH are elevated in EMS patients. The combined detection of the two indicators has good diagnostic efficacy for infertility in EMS patients, which is beneficial to the early clinical targeted treatment.

Key words: endometriosis, galectin 1, corticotropin-releasing hormone, infertility

中图分类号:

R711.71

图/表 7

参考文献 15

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组别	n		年龄（岁）	体质量指数（kg/m²）			月经量过多
对照组	90		34.18±8.71	20.89±1.11			32（35.56）
EMS组	93		34.02±7.26	21.14±1.06			41（44.09）
t或χ²			0.135	1.558			1.387
组别		痛经			流产	服用避孕药
对照组		24（26.67）			35（38.89）	52（57.78）
EMS组		53（56.99）			47（50.54）	61（65.59）
t或χ²		17.245^＊＊			2.509	1.182

组别	n		年龄（岁）	体质量指数（kg/m²）			月经量过多
对照组	90		34.18±8.71	20.89±1.11			32（35.56）
EMS组	93		34.02±7.26	21.14±1.06			41（44.09）
t或χ²			0.135	1.558			1.387
组别		痛经			流产	服用避孕药
对照组		24（26.67）			35（38.89）	52（57.78）
EMS组		53（56.99）			47（50.54）	61（65.59）
t或χ²		17.245^＊＊			2.509	1.182

组别	n	Gal-1（μg/L）	CRH（μg/L）	FSH（IU/L）	E2（ng/L）
对照组	90	5.17±1.23	4.03±1.08	2.59±0.75	45.16±14.03
EMS组	93	12.41±2.97	9.52±2.31	2.76±0.79	49.01±15.26
t		21.667^＊＊	20.700^＊＊	1.492	1.775

组别	n	Gal-1（μg/L）	CRH（μg/L）	FSH（IU/L）	E2（ng/L）
对照组	90	5.17±1.23	4.03±1.08	2.59±0.75	45.16±14.03
EMS组	93	12.41±2.97	9.52±2.31	2.76±0.79	49.01±15.26
t		21.667^＊＊	20.700^＊＊	1.492	1.775

因素	B	SE	Wald χ²	P	OR（95%CI）
痛经史	0.569	0.472	1.453	0.228	1.766（0.700~4.455）
Gal-1	0.625	0.298	4.399	0.036	1.868（1.042~3.350）
CRH	0.770	0.356	4.678	0.031	2.160（1.075~4.340）
常数项	-0.681	0.205	11.035	0.001	0.506