预测腹壁切口子宫内膜异位症严重程度的指标探讨

Exploring indicators for predicting the severity of endometriosis in abdominal incisions

目的探讨血红蛋白与红细胞分布宽度比(HRR)、中性粒细胞计数/淋巴细胞计数(NLR)、血小板计数/淋巴细胞计数(PLR)、淋巴细胞计数/单核细胞计数(LMR)在预测腹壁切口子宫内膜异位症(EMs)病情严重程度中的应用价值。方法收集2019年1月至2023年12月在中国科学技术大学附属第一医院(安徽省立医院)住院的205例腹壁切口EMs患者病历资料,参考美国生殖医学学会修订的EMs分期(R-AFS分期标准),根据病灶长径,将研究对象分为轻度组(119例,病灶长径≤3 cm)和重度组(86例,病灶长径>3 cm)。采用全自动血细胞分析仪检测并计算HRR、NLR、PLR、LMR。比较组间一般资料及HRR、NLR、PLR、LMR水平,绘制受试者工作特征(ROC)曲线分析HRR、NLR、PLR、LMR在腹壁切口EMs病情程度预测中的应用价值。结果重度组患者的年龄、潜伏期、病程、病灶长径、手术时间、出血量、糖类抗原125、中性粒细胞计数(NE)、NLR、PLR均高于轻度组,病理分型为腹膜型、补片、留置引流管、腹部包块有彩色多普勒超声血流的患者人数占比高于轻度组,HRR、LMR低于轻度组(P<0.05)。ROC曲线显示,HRR、NLR、PLR、LMR及4项指标联合预测重度腹壁切口EMs的曲线下面积(AUC)分别为0.653(0.611~0.695)、0.702(0.661~0.743)、0.617(0.572~0.662)、0.745(0.704~0.786)、0.823(0.719~0.927),4项指标联合评估的应用效能高于单一指标(P<0.05)。结论HRR、LMR在重度腹壁切口EMs患者中均较低,NLR、PLR在重度腹壁切口EMs患者中较高,均能反映腹壁切口EMs的严重程度。

Objective To explore the application value of hemoglobin,red blood cell distribution width ratio(HRR),neutrophil count/Lymphocyte count(NLR),platelet count/Lymphocyte count(PLR),lymphocyte count/monocyte count(LMR)in predicting the severity of endometriosis(EMs)in abdominal incisions.Methods Medical records of 205 patients with abdominal wall incision EMs admitted to the First Affiliated Hospital of the University of Science and Technology of China from January 2019 to December 2023 were collected.Referring to the revised R-AFS staging criteria of the American Society for Reproductive Medicine,the study subjects were divided into a mild group(119 cases,lesions≤3 cm)and a severe group(86 cases,lesions>3 cm)based on lesion size.Using a fully automated blood cell analyzer to detect and calculate HRR,NLR,PLR,LMR.Compare general information and HRR,NLR,PLR,LMR levels,plot receiver operating characteristic(ROC)curves between groups to analyze the application values of HRR,NLR,PLR,and LMR in predicting the severity of EMs in abdominal wall incisions.Results The age,latency,course of disease,lesion size,operation time,blood loss,CA125,NE,NLR and PLR of the severe group were higher than those of the mild group.The proportion of patients with pathological classification of peritoneal type,patch,indwelling drainage tube and color Doppler blood flow was higher than that of the mild group,and the HRR and LMR were lower than that of the mild group(P<0.05).According to the ROC curve,the area under the curve(AUC)of HRR,NLR,PLR,LMR,and the combination of four indicators for predicting severe abdominal wall incision EMs were 0.653(0.611-0.695),0.702(0.661-0.743),0.617(0.572-0.662),0.745(0.704-0.786),and 0.823(0.719-0.927),respectively.The application efficiency of the combined evaluation of the four indicators was higher than that of a single indicator(P<0.05).Conclusions Both HRR and LMR are lower in EMs for severe abdominal incision,while NLR and PLR are higher in EMs for severe abdominal incision,which can reflect the severity of EMs for severe abdominal incision.