摘要
目的:分析经阴道三维超声(3D-TVS)联合血清基质金属蛋白酶抑制因子-1(TIMP-1)、血管内皮细胞生长因子(VEGF)水平对宫腔粘连严重程度的诊断价值。方法:选取2022年9月—2024年9月某院78例宫腔粘连患者为观察组,同期行宫腔镜检查子宫内膜正常患者78例为对照组,比较2组3D-TVS参数[血管化血流指数(VFI)、血管指数(VI)、子宫内膜容积(EV)、血流指数(FI)]及血清TIMP-1、VEGF水平。根据观察组宫腔粘连严重程度分为轻度组(n=30)、中度组(n=27)和重度组(n=21),比较不同严重程度宫腔粘连患者3D-TVS参数及血清TIMP-1、VEGF水平。采用Spearman系数分析3D-TVS参数及血清TIMP-1、VEGF水平与宫腔粘连严重程度的相关性;绘制ROC曲线,分析3D-TVS联合血清TIMP-1、VEGF水平对宫腔粘连严重程度的诊断价值。结果:观察组VFI、VI、EV、FI值低于对照组,血清TIMP-1、VEGF水平高于对照组,差异有统计学意义(P<0.05)。不同严重程度宫腔粘连患者VFI、VI、EV、FI比较:轻度组>中度组>重度组;血清TIMP-1、VEGF水平比较:重度组>中度组>轻度组,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,VFI(r=-0.594)、VI(r=-0.548)、EV(r=-0.517)、FI(r=-0.638)与宫腔粘连严重程度呈负相关,血清TIMP-1(r=0.684)、VEGF(r=0.618)水平与宫腔粘连严重程度呈正相关(P<0.05)。ROC分析结果显示,3D-TVS联合血清TIMP-1、VEGF水平诊断中度宫腔粘连的AUC为0.921,敏感度为0.844,特异度为0.931;诊断重度宫腔粘连的AUC为0.948,敏感度为0.909,特异度为0.951。结论:3D-TVS检测的VFI、VI、EV、FI与宫腔粘连严重程度呈负相关,血清TIMP-1、VEGF水平与宫腔粘连严重程度呈正相关,3D-TVS联合血清TIMP-1、VEGF水平对宫腔粘连严重程度具有较高诊断价值,可为临床诊断及评估病情提供参考。
Objective:To analyze the diagnostic value of transvaginal three-dimensional ultrasound(3D-TVS)combined with serum levels of matrix metalloproteinase-1(TIMP-1)and vascular endothelial growth factor(VEGF)for the severity of intrauterine adhesions.Method:78 patients with intrauterine adhesions in a hospital from September 2022 to September 2024 were selected as the observation group,and 78 patients with normal endometrium who underwent hysteroscopy examination during the same period were selected as the control group.The 3D-TVS quantitative parameters[vascularized flow index(VFI),vascular index(VI),endometrial volume(EV),blood flow index(FI)]and serum TIMP-1 and VEGF levels were compared between the two groups.According to the severity of intrauterine adhesions,the patients in the observation group were re-divided into a mild group(n=30),a moderate group(n=27),and a severe group(n=21).3D-TVS quantitative parameters and serum TIMP-1 and VEGF levels were compared among patients with different degrees of intrauterine adhesions.Spearman was used to analyze the correlation of 3D-TVS quantitative parameters,serum TIMP-1 and VEGF levels with the severity of intrauterine adhesions.ROC curve was plotted to analyze the diagnostic value of 3D-TVS combined with serum TIMP-1 and VEGF levels for the severity of intrauterine adhesions.Results:The VFI,VI,EV,and FI values in the observation group were lower than those in the control group,while the serum levels of TIMP-1 and VEGF were higher,with statistically significant differences(P<0.05).Comparison of VFI,VI,EV,and FI in patients with different degrees of intrauterine adhesions was:mild group>moderate group>severe group.Comparison of serum TIMP-1 and VEGF levels was:severe group>moderate group>mild group,with statistically significant differences(P<0.05).Spearman correlation analysis showed that VFI(r=-0.594),VI(r=-0.548),EV(r=-0.517),FI(r=-0.638)were negatively correlated with the severity of intrauterine adhesions,while serum TIMP-1(r=0.684)and VEGF(r=0.618)levels were positively correlated with the severity of intrauterine adhesions(P<0.05).The ROC analysis results showed that the AUC,sensitivity,and specificity of 3D-TVS combined with serum TIMP-1 and VEGF levels for diagnosing moderate intrauterine adhesions were 0.921,0.844,and 0.931,respectively.The AUC for diagnosing severe intrauterine adhesions was 0.948,the sensitivity was 0.9092,and the specificity was 0.951.Conclusion:The quantitative parameters of 3D-TVS are negatively correlated with the severity of intrauterine adhesions,while the levels of serum TIMP-1 and VEGF are positively correlated with the severity of intrauterine adhesions.The combination of 3D-TVS and serum TIMP-1 and VEGF levels has high diagnostic value for the severity of intrauterine adhesions and can provide reference for clinical diagnosis and evaluation of the disease.
作者
陈小露
段运峥
CHEN Xiaolu;DUAN Yunzheng(Department of Gynaecology,Nanyang Central Hospital,Nanyang,Henan 473000,China)
出处
《淮海医药》
2025年第3期249-253,共5页
Journal of Huaihai Medicine
关键词
宫腔粘连
经阴道三维超声
基质金属蛋白酶抑制因子-1
血管内皮细胞生长因子
严重程度
诊断价值
Intrauterine adhesion
Transvaginal three-dimensional ultrasound
Matrix metalloproteinase inhibitor-1
Vascular endothelial growth factor
Severity
Diagnostic value
作者简介
陈小露(1990-),女,住院医师,大学。
