经会阴超声结合临床因素预测女性压力性尿失禁因素的可行性评估

Ting Xiao, WeiJun Huang, Xin-ling Zhang, Yunqing Cao, Chaojiong Zhen, Y. Wen
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引用次数: 0

摘要

目的探讨经会阴实时三维超声结合临床因素预测女性压力性尿失禁(SUI)风险的可行性和准确性。方法以确诊为SUI的女性患者348例为病例组,同期健康人群102例为对照组。所有受试者均行经会阴实时三维超声检查。测量静息状态、宫缩、Valsalva等超声参数,收集年龄、身高、体重、妊娠、分娩史等临床参数。按时间顺序将所有受试者按2∶1的比例分为衍生队列和验证队列,对24个因素进行单因素筛选和logistic多元回归分析,建立风险模型。通过受试者的ROC曲线确定疾病概率P的截断值,然后在验证组中验证截断值预测SUI的准确性。结果单因素分析有13项指标与SUI相关(P<0.05)。多因素logistic回归分析建立Logit P=2.014+ 1.870×Z1。ROC曲线确定的疾病概率P的截断值为0.823。该模型预测敏感性为68.1% (95%CI: 59.6% ~ 76.6%),特异性为91.2% (95%CI: 86.0% ~ 96.4%),阳性预测值为64.3% (95%CI: 55.6% ~ 73.0%),阴性预测值为92.5% (95%CI: 86.2% ~ 98.8%)。结论经会阴实时三维超声结合临床因素预测女性压力性尿失禁风险是可行的。虽然预测模型存在一定的局限性,但对有明显症状的SUI预测有一定的准确性。关键词:超声;会阴;Surinary尿失禁;模型;预测;风险
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Assessment of the feasibility of transperineal ultrasound combined with clinical factors in predicting female stress urinary incontinence factors
Objective To investigate the feasibility and accuracy of transperineal real-time three-dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence(SUI). Methods Three hundred and forty-eight female patients with SUI diagnosed were selected as the case group, and 102 healthy people in the same period were selected as the control group. All subjects underwent transperineal real-time three-dimensional ultrasound. The ultrasonic parameters of resting state, contraction and Valsalva were measured, and the clinical parameters such as age, height, weight, history of pregnancy and childbirth were collected. According to the time sequence, all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1, single factor screening and logistic multiple regression analysis were carried out on 24 factors, and the risk model was established. The cut-off value of the disease probability P was determined by the ROC curve of the subjects, and then the accuracy of the cut-off value in predicting SUI was verified in the verification group. Results Single factor analysis showed that 13 parameters were associated with SUI(all P<0.05). Logit P=2.014+ 1.870×Z1 was established by multivariate logistic regression analysis. The cut-off value of the disease probability P determined by ROC curve was 0.823. The predictive sensitivity of the model was 68.1% (95%CI: 59.6%-76.6%), specificity was 91.2% (95%CI: 86.0%-96.4%), positive predictive value was 64.3% (95%CI: 55.6%-73.0%) and negative predictive value was 92.5% (95%CI: 86.2%-98.8%). Conclusions It is feasible to predict the risk of female stress urinary incontinence by transperineal real-time three-dimensional ultrasound combined with clinical factors. Although, some limitations with the prediction model, it has accuracy in predicting SUI with obvious symptoms. Key words: Ultrasonography, transperineal; Surinary incontinence; Model; Predict; Risk
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中华超声影像学杂志
中华超声影像学杂志 Medicine-Radiology, Nuclear Medicine and Imaging
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9126
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