多囊卵巢综合征诱导排卵疗效预测模型的构建

Construction of a predictive model for ovulation induction therapy efficacy in polycystic ovary syndrome

  • 摘要:
    目的 分析多囊卵巢综合征(PCOS)患者诱导排卵疗效的影响因素,并构建PCOS患者诱导排卵疗效预测模型。
    方法 选取患有PCOS不孕且适用促排卵治疗的患者200例为研究对象。所有患者实施来曲唑或来曲唑联合尿促性素诱导排卵方案。按照诱导排卵的疗效分为有效组(n=160)和无效组(n=40)。回顾性收集、分析2组患者临床资料。采用Logistic回归分析法分析PCOS患者诱导排卵疗效的影响因素,并构建诱导排卵疗效的列线图预测模型。评估PCOS患者诱导排卵疗效的列线图模型的预测效能。
    结果 有效组的排卵数、排卵例数占比、成熟卵泡数目、子宫内膜厚度大于无效组,雄激素水平低于无效组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,雄激素、排卵数、成熟卵泡数目、子宫内膜厚度是PCOS患者诱导排卵疗效的影响因素(OR<1, P<0.05)。受试者工作特征(ROC)曲线分析显示,排卵数、成熟卵泡数目、子宫内膜厚度、雄激素水平评估PCOS患者诱导排卵疗的曲线下面积(AUC)值大于0.60。列线图预测模型验证结果显示,校准曲线的一致性指数值为0.984。
    结论 雄激素、排卵数、成熟卵泡数目和子宫内膜厚度为PCOS患者诱导排卵疗效的影响因素,基于上述因素构建的列线图预测模型的评估效能较好。

     

    Abstract:
    Objective  To analyze the influencing factors of ovulation induction therapy in patients with polycystic ovary syndrome (PCOS), and to construct a predictive model for the efficacy of ovulation induction therapy in PCOS patients.
    Methods  A total of 200 infertile PCOS patients suitable for ovulation induction therapy were selected as the study subjects.All patients underwent ovulation induction with letrozole or letrozole combined with urinary gonadotropins. They were divided into effective group (n=160) and ineffective group (n=40) based on the efficacy of ovulation induction. The clinical data of the two groups were retrospectively collected and analyzed. Logistic regression analysis was used to analyze the influencing factors of ovulation induction therapy in PCOS patients, and a nomogram prediction model for the efficacy of ovulation induction was constructed. The predictive performance of the nomogram model for ovulation induction therapy in PCOS patients was evaluated.
    Results  The number of ovulations and mature follicles, proportion of ovulation patients and endometrial thickness in the effective group were significantly higher, and the androgen level in the effective group was significantly lower than that in the ineffective group (P<0.05). Logistic regression analysis showed that androgen level, ovulation count, the number of mature follicles and endometrial thickness were influencing factors for the efficacy of ovulation induction in PCOS patients (OR<1, P<0.05). Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) values for ovulation count, the number of mature follicles, endometrial thickness and androgen level in assessing the efficacy of ovulation induction therapy in PCOS patients were greater than 0.60. The verification results of the nomogram prediction model showed that the consistency index value of the calibration curve was 0.984.
    Conclusions  Androgen level, ovulation count, the number of mature follicles and endometrial thickness areinfluencing factors for the efficacy of ovulation induction therapy in PCOS patients. The evaluation performance of the nomogram prediction model based on the above factors is good.

     

/

返回文章
返回