国际妇产科学杂志

国际妇产科学杂志 ›› 2015, Vol. 42 ›› Issue (6): 705-707.

• 论著 • 上一篇    下一篇

EMs生育指数对Ⅲ～Ⅳ期EMs合并不孕术后非ART妊娠结局的预测价值

李晓虹，曾荔苹，何芳，沈雪歌，汤惠茹，吴瑞芳   

  1. 518036 广东省深圳市，北京大学深圳医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-12-15 发布日期:2015-12-15
  • 通讯作者: 汤惠茹

The Value of Endometriosis Fertility Index in Predicting the None-ART Pregnancy Outcome after Laparoscopic for Stage Ⅲ or Stage Ⅳ Endometriosis-associated Infertility

LI Xiao-hong，ZENG Li-ping，HE Fang，SHEN Xue-ge，TANG Hui-ru，WU Rui-fang   

  1. Peking University of Shenzhen Hospital，Shenzhen 518036，Guangdong Province，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-12-15 Online:2015-12-15
  • Contact: TANG Hui-ru

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摘要： 目的：探讨子宫内膜异位症生育指数（EFI）对中重度（Ⅲ～Ⅳ期）子宫内膜异位症（EMs）相关不孕术后非辅助生殖技术（ART）妊娠结局的预测价值。方法：回顾性分析北京大学深圳医院2011年1 月—2012 年12 月行腹腔镜手术治疗的Ⅲ～Ⅳ期EMs合并不孕患者48例，按照EFI评分标准进行评分，随访其妊娠结局。结果：48 例患者术后2年累积非ART妊娠25例（52.1%），术后6个月非ART妊娠20例（41.7%），术后7～12个月非ART妊娠4例（8.3%），术后13～24个月非ART妊娠1例（2.1%），随访不同时间段非ART妊娠率差异有统计学意义（χ2=30.301，P=0.000）。术后2年累积非ART妊娠率与EFI 评分及术后是否使用促排卵治疗有关（P＜0.05），而与r-AFS 分期无关（P＞0.05）。EFI 评分的受试者工作特征（ROC）曲线下面积（AUC）为0.681（95%CI：0. 527～0. 834，P=0.033）。通过ROC 曲线确定的EFI 预测术后2 年内非ART妊娠的临界值为5.5分（约登指数最大），其预测的敏感度为85.2%，特异度为42.9%。结论：EFI对于中重度EMs合并不孕患者术后非ART妊娠率有较好的预测价值。

关键词: 子宫内膜异位症, 生育指数, 妊娠率, 不育, 女（雌）性, 腹腔镜

Abstract: Objective：To assess the value of endometriosis fertility index（EFI） in predicting the none-ART pregnancy outcome after conservative surgery for stage Ⅲ-Ⅳ endometriosis（EMs）-associated infertility. Methods：Medical documents of 48 infertile patients who were confirmed of stage Ⅲ-Ⅳ EMs by laparoscopy were retrospectively studied from January 2011 to December 2012 in Peking University of Shenzhen Hospital, The EFI score was calculated on history and detailed surgical findings. All patients were followed up to assess fertility outcome. Results：The overall postoperative none-ART pregnancy rate within 24 months was 52.1%. The postoperative none-ART pregnancy rate was 41.7%，8.3% and 2.1% in the first six month, the 7 to 12 months and the 13 to 24 months, there were statistically difference at the diffierent periods of follow-up （χ2=30.301，P=0.000）. The postoperative none-ART pregnancy rate was correlated with EFI scoring and ovarian simulation （P＜0.05）. However, the postoperative pregnancy rate had no correlation with r-AFS staging（P＞0.05）. ROC curve analysis of EFI showed that the area under curve was 0.681（95% CI：0. 527-0. 834，P=0.033）. The critical value of pregnancy predicted by EFI within two years after the operation was 5.5, with sensitivity of 85.2% and specificity of 42.9%. Conclusions：EFI scores could well predict none-ART pregnancy rate in patients with stage Ⅲ- Ⅳ EMs -associated infertility. EFI scores may be used to guide postoperative treatment.

Key words: Endometriosis, Fertility index, Pregnancy rate, Infertility, female, Laparoscopes