| 丁莹,周春桥,蒋丹华,韦芳桃,胡慧云,黎新艳.基于LASSO回归建立模型预测清宫术后剖宫产瘢痕妊娠残留[J].中国医学影像技术,2023,39(12):1847~1851 |
| 基于LASSO回归建立模型预测清宫术后剖宫产瘢痕妊娠残留 |
| Establishing prediction model for retained cesarean scar pregnancy after curettage based on LASSO regression |
| 投稿时间：2023-06-27 修订日期：2023-10-30 |
| DOI：10.13929/j.issn.1003-3289.2023.12.024 |
| 中文关键词: 妊娠,异位 刮宫术 回归分析 危险因素 |
| 英文关键词:pregnancy, ectopic dilatation and curettage regression analysis risk factors |
| 基金项目:广西重点研发计划（桂科AB23026011）。 |
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| 中文摘要: |
| 目的 基于LASSO回归建立风险预测模型，观察其预测清宫术后剖宫产瘢痕妊娠（CSP）残留的价值。方法 回顾性分析接受超声引导下清宫术的401例CSP患者，按比例7：3随机将其分为训练集（n=264）及验证集（n=137）；根据清宫术后宫腔下段瘢痕处有无残留分为残留组和无残留组，以LASSO回归选择对预测术后CSP残留最有价值的变量，再以多变量logistic回归分析筛选CSP清宫术后残留的独立危险因素，并以之构建列线图模型。结果 LASSO回归分析和多因素logistic回归结果表明，孕囊嵌入瘢痕深度>1.13 cm、孕囊外凸、富血供（Adler Ⅱ~Ⅲ级）及清宫术前血清β-人绒毛膜促性腺激素（HCG）>33 063.50 U/L均为术后CSP残留的独立危险因素（P均<0.05）；基于上述指标建立模型的列线图的预测校准曲线与理想曲线基本一致；模型临床获益较好。结论 所获模型对清宫术后CSP残留具有较好预测能力。 |
| 英文摘要: |
| Objective To establish a risk prediction model, and to observe its value for predicting retained cesarean scar pregnancy (CSP)after ultrasound-guided curettage. Methods Data of 401 CSP patients who received ultrasound-guided curettage were retrospectively analyzed. The patients were randomly divided into training set (n=264) or validation set (n=137) at a ratio of 7:3. According to whether there was retained CSP at the lower segmental scar of uterine after ultrasound-guided curettage, the patients were divided into retained group or non-retained group. The variables with the biggest predictive value for retained CSP after ultrasound-guided curettage were selected with LASSO regression, and the independent risk factors were screened using multivariate logistic regression, and then a nomogram model was established.Results The results of LASSO regression and multivariate logistic regression indicated that embedded depth of gestational sac in cesarean scar more than 1.13 cm, convexity of gestational sac, rich blood supply (Adler degree Ⅱ-Ⅲ), and pre-curettage serum β-human chorionic gonadotropin (HCG) more than 33 063.50 U/L were all independent risk factors for retained CSP after curettage (all P<0.05). The calibration curve of nomogram predictive model established based on the above indexes was basically consistent with the ideal curve, and the model had good clinical benefits. Conclusion The established nomogram predictive model had good predictive ability for retained CSP after curettage. |
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