Gynecology Department, Qingdao Jiaozhou Central Hospital, 266300 Qingdao, Shandong, China.
Equipment Department, Tai'an Maternal and Child Health Hospital, 271000 Tai'an, Shandong, China.
Arch Esp Urol. 2023 May;76(3):232-237. doi: 10.56434/j.arch.esp.urol.20237603.26.
This study aimed to explore the risk factors of patients with endometriosis (EMS) and ureteral stricture and to establish a prediction model based on logistic-regression analysis.
The clinical data of 228 EMS patients in Jiaozhou Central Hospital of Qingdao from May 2019 to May 2022 were selected for a retrospective study. According to the results of ureteroscopic biopsy, they were divided into concurrent (n = 32) and nonconcurrent (n = 196) groups. Univariate analysis was performed on the general data and situations of clinical treatment in both groups. Single factor with statistically significant differences was included in unconditional logistic-regression analysis with multiple factors to explore the risk factors of such patients and establish a prediction model.
Overt differences were found in previous history of ureter operation (odds ratio (OR) = 3.711, = 0.006), course of EMS (OR = 3.987, = 0.007), presence or absence of haematuria (OR = 3.586, = 0.009) and lateral abdominal pain (OR = 4.451, = 0.002), and invasion depth of lesion (OR = 7.271, < 0.001) between the two groups ( < 0.05), without distinct difference in age, menstrual duration, BMI values, history of dysmenorrhea, previous history of drug therapy, smoking history, and drinking history ( > 0.05). Logistic-regression analysis showed that previous history of ureter operation (a1), course of EMS (b2), occurrence of haematuria (c3) and lateral abdominal pain (d4), and invasion depth of lesion ≥5 mm (e5) were risk factors for EMS combined with ureteral stricture ( < 0.05), taking logit () = -4.990 + 1.311a1 + 1.383b2 + 1.277c3 + 1.493d4 + 1.984e5 as regression model. The receiver operating characteristic (ROC) curve analysis based on this model showed that the area under the curve (AUC), standard error, and 95% confidence interval (CI) were 0.813, 0.062, and 0.692-0.934, respectively. One hundred EMS patients were re-included, whose values for predictive sensitivity, specificity, and kappa coefficient were 71.40%, 91.10% and 0.615.
Previous history of ureter operation, course of EMS, occurrence of haematuria and lateral abdominal pain, and invasion depth of lesion ≥5 mm were risk factors for EMS combined with ureteral stricture. Therefore, the use of this model has a certain clinical value.
本研究旨在探讨子宫内膜异位症（EMS）合并输尿管狭窄患者的危险因素，并基于逻辑回归分析建立预测模型。
回顾性分析 2019 年 5 月至 2022 年 5 月期间在青岛胶州中心医院接受治疗的 228 例 EMS 患者的临床资料。根据输尿管镜活检结果，将患者分为并发（n=32）和非并发（n=196）组。对两组患者的一般资料和临床治疗情况进行单因素分析。将单因素分析中有统计学意义的变量纳入多因素非条件逻辑回归分析，探讨此类患者的危险因素，并建立预测模型。
两组患者在输尿管手术史（优势比（OR）=3.711， =0.006）、EMS 病程（OR=3.987， =0.007）、血尿（OR=3.586， =0.009）和侧腹痛（OR=4.451， =0.002）以及病变浸润深度（OR=7.271， <0.001）方面存在明显差异（ <0.05），年龄、月经持续时间、BMI 值、痛经史、药物治疗史、吸烟史和饮酒史方面无明显差异（ >0.05）。逻辑回归分析表明，输尿管手术史（a1）、EMS 病程（b2）、血尿（c3）和侧腹痛（d4）以及病变浸润深度≥5 mm（e5）是 EMS 合并输尿管狭窄的危险因素（ <0.05），回归模型为logit（）=-4.990+1.311a1+1.383b2+1.277c3+1.493d4+1.984e5。基于该模型的受试者工作特征（ROC）曲线分析显示，曲线下面积（AUC）、标准误差和 95%置信区间（CI）分别为 0.813、0.062 和 0.692-0.934。纳入 100 例 EMS 患者进行重新分析，预测敏感度、特异度和 Kappa 系数分别为 71.40%、91.10%和 0.615。
输尿管手术史、EMS 病程、血尿和侧腹痛以及病变浸润深度≥5 mm 是 EMS 合并输尿管狭窄的危险因素。因此，该模型具有一定的临床应用价值。
