血清TGF-β1与输卵管炎性阻塞性不孕症患者输卵管疏通术后自然妊娠失败的相关性分析

Correlation analysis between serum transforming growth factorβ1 and spontaneous pregnancy failure in patients with salpingitic obstructive infertility after tubal dredging

目的探讨血清转化生长因子-β1(TGF-β1)与输卵管炎性阻塞性不孕症(SOI)患者输卵管疏通术后自然妊娠失败的相关性。方法选取2020年1月至2022年1月济南市第二妇幼保健院收治的305例SOI患者作为研究对象。术前检测患者血清TGF-β1水平,随访统计患者自然妊娠情况。采用点二列相关性、Logistic回归模型及受试者工作特征(ROC)曲线检验血清TGF-β1水平与SOI患者输卵管疏通术后自然妊娠情况的相关性及其预测价值。结果失访8例,297例SOI患者术后自然妊娠失败113例(38.05%);不同年龄、不孕时间的SOI患者术后自然妊娠情况比较,差异具有统计学意义(P<0.05)。TGF-β1高水平组术后自然妊娠失败率高于低水平组,差异具有统计学意义(P<0.05)。经点二列相关性分析显示,SOI患者术后自然妊娠情况与血清TGF-β1水平呈正相关(P<0.05)。经Logistic回归分析,在调整年龄、不孕时间后,以血清TGF-β1低水平为参照,血清TGF-β1高水平是SOI患者术后自然妊娠的危险因素。ROC曲线显示,术前血清TGF-β1水平预测SOI患者术后自然妊娠具有一定的预测价值(曲线下面积=0.711,95%CI:0.650~0.772,P<0.05)。结论血清TGF-β1水平与SOI患者术后自然妊娠率具有相关性,可作为预测患者自然妊娠风险的指标。

Objective To investigate the correlation between serum transforming growth factor(TGF)β1 and spontaneous pregnancy failure in patients with salpingitic obstructive infertility(SOI)after tubal dredging.Methods A total of 305 SOI patients admitted to the Second Children&Women′s Healthcare of Jinan City from January 2020 to January 2022 were selected as the study subjects.The level of serum TGF-β1 was detected before operation,and the natural pregnancy condition of the patients was followed up.The correlation between serum TGF-β1 level and natural pregnancy condition after tubal recanalization in SOI patients and its predictive value were tested by Point Biserial correlation,Logistic regression model and receiver operating characteristic(ROC)curve.Results A total of 8 cases were lost to follow-up.Of the 297 patients with SOI,113 cases(38.05%)had spontaneous pregnancy failure after surgery.There was a statistically significant difference in the natural pregnancy condition of SOI patients after surgery with different ages and infertility duration(P<0.05).The spontaneous pregnancy failure rate in the high-level group of TGF-β1 was higher than that in the low-level group,with a statistical significant difference(P<0.05).Point Biserial correlation analysis showed that there was a positive correlation between spontaneous pregnancy and serum TGF-β1 levels in patients with SOI after surgery(P<0.05).Logistic regression analysis showed that after adjusting for age and infertility duration,taking low serum TGF-β1 levels as a reference,high serum TGF-β1 level was a risk factor for spontaneous pregnancy in patients with SOI after surgery.The ROC curve showed that preoperative serum TGF-β1 levels had a certain predictive value in predicting postoperative spontaneous pregnancy in patients with SOI(areas under curve=0.711,95%CI:0.650-0.772,P<0.05).Conclusions There is a correlation between serum TGF-β1 level and spontaneous pregnancy rate in patients with SOI,which can be used as a predictor of spontaneous pregnancy risk.