孕早期先兆流产危险因素的Logistic回归分析
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摘要
目的研究孕早期先兆流产的危险因素,为先兆流产患者治疗提供帮助。方法选取2016年5月至2017年8月于佛山市高明区人民医院就诊的100例先兆流产患者为研究组,选择同期正常妊娠孕妇100例为对照组,就两组年龄结构、体质量指数、文化程度、职业结构、既往流产史、孕酮水平、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)等因素进行对比分析,将其中有统计学差异的指标进行多因素Logistic回归分析,研究孕早期先兆流产患者的危险因素,同时计算各因素与先兆流产的关联强度及95%CI区间范围。结果单因素分析结果显示:两组在年龄结构、既往流产史、孕酮水平、IGF-1含量方面比较,差异有统计学意义(P<0.05);两组在体质量指数、文化程度、职业结构方面比较,差异无统计学意义(P>0.05)。Logistic回归分析结果提示,IGF-1的低表达、孕酮水平降低、既往流产史是先兆流产的独立危险因子(P<0.05),关联强度及95%CI区间范围分别为:5.436(2.471～12.106)、3.710(1.643～8.402)、3.341(1.613～7.414)。结论孕早期先兆流产受IGF-1水平降低、孕酮低表达及既往流产史影响较大,有针对性地纠正上述指标为先兆流产治疗提供了思考方向。
Objective To study the risk factors of threatened abortion in the first trimester to help treat patients with threatened abortion.Methods 100 patients with threatened abortion who were treated in the People's Hospital of Gaoming from May 2016 to August 2017 were selected as the study group. 100 pregnant women with normal pregnancy were selected as the control group. Comparative analysis was carried out on the age structure, body mass index, education level, occupational structure, history of previous abortion, progesterone level, and insulin-like growth factor 1(IGF-1). Multivariate logistic regression analysis was performed to study the risk factors of threatened abortion patients in early pregnancy, and to calculate the correlation intensity of each factor with threatened abortion and the 95 % CI range. Results Univariate analysis showed that the age group, previous abortion history, progesterone level, and IGF-1 levels were compared, and the difference was statistically significant(P<0.05). The body mass index, education level, and occupational structure were compared between the two groups,the difference was not statistically significant(P>0.05). Logistic regression analysis showed that low expression of IGF-1, decreased progesterone results, and previous abortion history were independent risk factors for threatened abortion(P<0.05), and the correlation intensity and 95% CI interval range were 5.436(2.471 to 12.106), 3.710(1.643 to 8.402), 3.341(1.613 to 7.414). Conclusion Threatened abortion in early pregnancy is affected by decreased IGF-1 levels, low expression of progesterone and previous abortion history. Targeted correction of these indicators provides a direction for the treatment of threatened abortion.
Objective To study the risk factors of threatened abortion in the first trimester to help treat patients with threatened abortion.Methods 100 patients with threatened abortion who were treated in the People's Hospital of Gaoming from May 2016 to August 2017 were selected as the study group. 100 pregnant women with normal pregnancy were selected as the control group. Comparative analysis was carried out on the age structure, body mass index, education level, occupational structure, history of previous abortion, progesterone level, and insulin-like growth factor 1(IGF-1). Multivariate logistic regression analysis was performed to study the risk factors of threatened abortion patients in early pregnancy, and to calculate the correlation intensity of each factor with threatened abortion and the 95 % CI range. Results Univariate analysis showed that the age group, previous abortion history, progesterone level, and IGF-1 levels were compared, and the difference was statistically significant(P<0.05). The body mass index, education level, and occupational structure were compared between the two groups,the difference was not statistically significant(P>0.05). Logistic regression analysis showed that low expression of IGF-1, decreased progesterone results, and previous abortion history were independent risk factors for threatened abortion(P<0.05), and the correlation intensity and 95% CI interval range were 5.436(2.471 to 12.106), 3.710(1.643 to 8.402), 3.341(1.613 to 7.414). Conclusion Threatened abortion in early pregnancy is affected by decreased IGF-1 levels, low expression of progesterone and previous abortion history. Targeted correction of these indicators provides a direction for the treatment of threatened abortion.
引文
[1] 纪诚,刘莹钰,李硕,等.产妇孕期先兆流产的发生情况及影响因素分析 [J].中国实验诊断学,2017,21(4):617-619.
[2] 付州,连方,孙振高.先兆流产预后评估指标研究进展 [J].山东医药,2014,54(8):90-92.
[3] 张崇移,章林燕,周秀萍,等.220例早期先兆流产妊娠结局分析 [J].中国妇幼保健,2011,26(16):2491-2492.
[4] 杨洋,丁莉莉,纪学芹.先兆流产患者年龄、既往流产次数与保胎结局的关系 [J].宁夏医科大学学报,2014,36(2):229-231.
[5] 胡萍芳,杨爱平,陈玉洁,等.先兆流产的常见病因及相关实验室指标 [J].中国卫生检验杂志,2015,25(21):3789-3792.
[6] 孙巧霞,王柳,随璐.育龄妇女孕早期自然流产相关危险因素分析 [J].中国基层医药,2015,22(7):1094-1095.
[7] 符梅,徐克惠.复发性自然流产夫妇的病因分析 [J].中华妇幼临床医学杂志(电子版),2016,12(4):395-400.
[8] JANOWICZ-GRELEWSKA A, SIEROSZEWSKI P.Prognostic significance of subchorionic hematoma for the course of pregnancy [J].Ginekologia Polska, 2013, 84 (11): 944-949.
[9] 赵卓姝,张秀群,李越.早期先兆流产产妇的妊娠结局相关因素的 Logistic 回归分析[J].右江民族医学院学报,2015,37(2):258-259.
[10] 焦丽敏.影响先兆流产妊娠结局的相关因素分析 [J].中国医药科学,2016,6(18):150-152.
[11] 袁海琳,吴庆丽.肥胖在流产中的作用研究新进展 [J].国际生殖健康/计划生育杂志,2014,33(4):325-328.
[12] 刘玉昆,刘梅兰,杜涛,等.不同年龄和流产次数的复发性流产患者绒毛染色体核型分析 [J].现代妇产科进展,2012,21(12):925-928.
[13] 周璐,赵珊琼.345例早期先兆流产孕妇中西医结合保胎后产前筛查结果分析 [J].中国妇幼保健,2012,27(28):4432-4433.
[14] 刘玉昆,陈欣,刘颖琳,等.高龄早期复发性流产患者流产原因分析 [J].中山大学学报(医学科学版),2013,34(4):646-650, 封3.
[15] 黄玉华,柯海,魏颖楠,等.1 010例早期先兆流产患者中医证型分布及妊娠结局相关因素分析 [J].中国中医药信息杂志,2017,24(8):22-26.
[16] 谢瑞兰,李斌,张海青,等.252例先兆流产妇女妊娠结局及相关因素分析 [J].医学研究杂志,2006,35(1):28-30.
[17] 刘晓华,岳洁,卢钺,等.先兆流产合并绒毛膜下血肿孕妇孕早期激素水平与妊娠结局的相关性分析 [J].海南医学院学报,2016,22(4):361-363.
[18] 许瑾平,王慧青,郭春兰.先兆流产的影响因素分析及妊娠结局评估 [J].中国药物与临床,2015,15(9):1317-1320.
[19] 许琳,吴玲,林强,等.影响先兆流产妊娠结局的相关因素分析 [J].海南医学院学报,2011,17(5):653-655.
[20] 周蔺.先兆流产相关影响因素及妊娠结局的病例对照研究 [J].中医临床研究,2014,6(24):132-134.
[2] 付州,连方,孙振高.先兆流产预后评估指标研究进展 [J].山东医药,2014,54(8):90-92.
[3] 张崇移,章林燕,周秀萍,等.220例早期先兆流产妊娠结局分析 [J].中国妇幼保健,2011,26(16):2491-2492.
[4] 杨洋,丁莉莉,纪学芹.先兆流产患者年龄、既往流产次数与保胎结局的关系 [J].宁夏医科大学学报,2014,36(2):229-231.
[5] 胡萍芳,杨爱平,陈玉洁,等.先兆流产的常见病因及相关实验室指标 [J].中国卫生检验杂志,2015,25(21):3789-3792.
[6] 孙巧霞,王柳,随璐.育龄妇女孕早期自然流产相关危险因素分析 [J].中国基层医药,2015,22(7):1094-1095.
[7] 符梅,徐克惠.复发性自然流产夫妇的病因分析 [J].中华妇幼临床医学杂志(电子版),2016,12(4):395-400.
[8] JANOWICZ-GRELEWSKA A, SIEROSZEWSKI P.Prognostic significance of subchorionic hematoma for the course of pregnancy [J].Ginekologia Polska, 2013, 84 (11): 944-949.
[9] 赵卓姝,张秀群,李越.早期先兆流产产妇的妊娠结局相关因素的 Logistic 回归分析[J].右江民族医学院学报,2015,37(2):258-259.
[10] 焦丽敏.影响先兆流产妊娠结局的相关因素分析 [J].中国医药科学,2016,6(18):150-152.
[11] 袁海琳,吴庆丽.肥胖在流产中的作用研究新进展 [J].国际生殖健康/计划生育杂志,2014,33(4):325-328.
[12] 刘玉昆,刘梅兰,杜涛,等.不同年龄和流产次数的复发性流产患者绒毛染色体核型分析 [J].现代妇产科进展,2012,21(12):925-928.
[13] 周璐,赵珊琼.345例早期先兆流产孕妇中西医结合保胎后产前筛查结果分析 [J].中国妇幼保健,2012,27(28):4432-4433.
[14] 刘玉昆,陈欣,刘颖琳,等.高龄早期复发性流产患者流产原因分析 [J].中山大学学报(医学科学版),2013,34(4):646-650, 封3.
[15] 黄玉华,柯海,魏颖楠,等.1 010例早期先兆流产患者中医证型分布及妊娠结局相关因素分析 [J].中国中医药信息杂志,2017,24(8):22-26.
[16] 谢瑞兰,李斌,张海青,等.252例先兆流产妇女妊娠结局及相关因素分析 [J].医学研究杂志,2006,35(1):28-30.
[17] 刘晓华,岳洁,卢钺,等.先兆流产合并绒毛膜下血肿孕妇孕早期激素水平与妊娠结局的相关性分析 [J].海南医学院学报,2016,22(4):361-363.
[18] 许瑾平,王慧青,郭春兰.先兆流产的影响因素分析及妊娠结局评估 [J].中国药物与临床,2015,15(9):1317-1320.
[19] 许琳,吴玲,林强,等.影响先兆流产妊娠结局的相关因素分析 [J].海南医学院学报,2011,17(5):653-655.
[20] 周蔺.先兆流产相关影响因素及妊娠结局的病例对照研究 [J].中医临床研究,2014,6(24):132-134.
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