子宫内膜息肉病因及其术后复发因素的Logistic回归分析

Logistic regression analysis of etiologies and postoperative recurrence factors of endometrial polyps

目的探讨子宫内膜息肉疾病成因及其术后复发的因素并进行Logistic回归分析,为子宫内膜息肉患者防控提供循证依据。方法选择2018年1月至2020年6月到高明区人民医院就诊的子宫内膜息肉患者115例为研究组,选择同期到高明区人民医院健康体检的人群100例为对照组,分别就两组文化结构、职业结构、体重指数、雌激素受体感染等因素进行多因素对比分析,探讨导致子宫内膜息肉疾病成因;对前述有统计学差异的指标进行多因素Logistic回归分析,讨论导致子宫内膜息肉高危因素;追踪分析手术摘除子宫内膜息肉患者2年后子宫内膜息肉复发的因素进行归纳总结,探讨子宫内膜息肉术后复发的易感因素。结果研究组及对照组在文化程度、职业结构方面无统计学差异(P>0.05);研究组体重指数、子宫内膜局部雌激素受体(estrogen receptor,ER)和孕激素受体(progesterone receptor,PR)的表达显著高于对照组(P<0.05),感染及炎症发病率显著高于对照组(P<0.05),研究组CD4、CD8表达异常率与对照组比较差异有统计学意义(P<0.05);Logistic回归分析结果提示:内分泌失调、免疫细胞的异常表达、肥胖、高血压是子宫内膜息肉复发的独立危险因子(P<0.05),关联强度(OR值)及95%CI区间范围分别为:5.631(2.579~9.186)、3.872(1.943~10.142)、3.731(1.596~8.014)、6.637(1.779~9.082)。结论肥胖及雌激素受体的过表达、局部免疫失衡可能是导致子宫内膜息肉的发病因素,而纠正内分泌失调、免疫细胞的异常表达可成为临床防范子宫内膜息肉术后复发的优先考虑方向。

Objective To investigate the etiologies of endometrial polyps and the postoperative recurrence factors,and carry out Logistic regression analysis,so as to provide evidence-based foundation for the prevention and control of endometrial polyps.Methods Patients with endometrial polyps admitted to People's Hospital of Gaoming District in Foshan City from January 2018 to June 2020 were selected as the study group(n=115),while healthy people undergoing physical examination in People's Hospital of Gaoming District in Foshan City in the same period were selected as the control group(n=100).The multiple factors such as cultural structure,occupational structure,body mass index(BMI)and estrogen receptor infection in the two groups were compared and analyzed,respectively,and the etiologies of endometrial polyps were investigated.Multivariate Logistic regression analysis was carried out on the above-mentioned statistically different indices to investigate the high-risk factors leading to endometrial polyps.The factors of recurrence of endometrial polyps 2 years after surgical removal were analyzed and summarized,and the predisposing factors of recurrence of endometrial polyps after surgery were investigated.Results There were no statistically significant differences in the aspects of education level and occupational structure between the study group and the control group(P>0.05).The BMI,the expression of estrogen receptor(ER)and progesterone receptor(PR)in the local endometrium of the study group were significantly higher than those of the control group(P<0.05).And the incidences of infection and inflammation were significantly higher than those in the control group(P<0.05).There were statistically significant differences in the incidences of abnormal expression of CD4 and CD8 between the study group and the control group(P<0.05).Logistic regression analysis results showed that endocrine disorders,abnormal expression of immune cells,obesity and hypertension were independent risk factors for recurrence of endometrial polyps(P<0.05).The odds ratio(OR)values and 95%CI ranges were 5.631(2.579-9.186),3.872(1.943-10.142),3.731(1.596-8.014)and 6.637(1.779-9.082),respectively.Conclusion Obesity,over-expression of ER and local immune imbalance may be the etiologies of endometrial polyps.And the correction of endocrine disorders and abnormal expression of immune cells may be the priority of clinical prevention for postoperative recurrence of endometrial polyps.