多囊卵巢综合征患者宫颈机能不全发生情况及其发生的高危因素

The incidence of cervical incompetence (CI) and the high risk factors of CI in polycystic Ovary Syndrome (PCOS) patients

目的 探讨孕晚期流产患者中多囊卵巢综合征(PCOS)患者宫颈机能不全(CI)发生情况及CI发生的高危因素。方法 将2015年2月-2019年6月期间南京市妇幼保健院及南京市溧水区人民医院收治的80例孕晚期流产者作为研究对象,采用鹿特丹标准法分为PCOS组(23例)和非PCOS组(57例),对比组别临床资料、CI率,并分析影响CI发生高危因素。结果 PCOS组别与非PCOS组别相比,后者平均年龄较大、孕前BMI值较低、基础FSH值较高、基础LH值与T水平较低、不孕类型多以继发不孕为主。晚期流产人群中出现CI病例有13例,发生概率为16.25%,纳入研究的病例中PCOS组别CI发生率显著高于非PCOS组别CI发生率。PCOS组别单胎、双胎CI发生率同时高于非PCOS组别的单胎、双胎CI发生率。将子宫平均径线4cm为区分界限将患者分别两个组别,结果显示PCOS的CI发生率均高于非PCOS者。CI患者子宫平均经线短于非CI者(P<0.05),血清T水平高于非CI者(P<0.05)。应用Logistic回归性分析,结果表明排除其他类混杂因素,PCOS的疾病状态为CI的高危因素(OR 3.916,95%CI 1.535-9.975),子宫平均经线<4cm(OR 4.338,95%CI 1.698-11.015),以上两项为高危因素。结论 对于孕晚期流产患者,PCOS者CI的发生概率显著高于非PCOS者,但PCOS者子宫平均径线短于非PCOS者。影响CI发生的主要高危因素为PCOS疾病状况及子宫平均径线长度。

Objective To investigate the incidence and risk factors of cervical incompetence(CI)in patients with polycystic ovary syndrome(PCOS)in late pregnancy abortion.Methods 80patients with late pregnancy abortion in women’s hospital of Nanjing medical university and Nanjing Lishui people’s hospital from February 2015to June 2019were divided into PCOS group(n=23)and non PCOS group(n=57)by Rotterdam standard method.The clinical data,incidence of CI and risk factors of CI were compared between the two groups.Results Compared with the non PCOS group,the PCOS group had higher average age,lower pre pregnancy BMI,higher basal FSH,lower basal LH and T levels,and the main type of infertility was secondary infertility.There were 13cases of CI in the late abortion group,and the incidence rate was 16.25%.The incidence rate of CI in the PCOS group was significantly higher than that in the non PCOS group.The incidence of CI in PCOS group was higher than that in non PCOS group.The results showed that the incidence of CI in PCOS patients was higher than that in non PCOS patients.The mean uterine meridian of CI patients was shorter than that of non CI patients(P<0.05),and the serum T level was higher than that of non CI patients(P<0.05).Logistic regression analysis showed that excluding other confounding factors,the disease status of PCOS was the high risk factor of CI(or 3.916,95% CI 1.535-9.975),and the average uterine meridian<4cm(or 4.338,95% CI1.698-11.015).Conclusion for patients with late pregnancy abortion,the probability of CI in PCOS patients is significantly higher than that in non PCOS patients,but the mean uterine diameter in PCOS patients is shorter than that in non PCOS patients.The main risk factors of CI were PCOS disease status and average uterine diameter.