| 摘要: |
| ［摘要］ 目的 探讨血清D-二聚体（D-D）、B淋巴细胞活化因子（BAFF）、雌二醇（E2）水平与子宫内膜异位症（EMs）合并不孕患者冻融胚胎移植（FET）结局的关联性。方法 招募2022年8月至2024年8月唐山市妇幼保健院生殖遗传科收治的EMs合并不孕患者116例，根据FET结局将其分为妊娠组（n=64）和未妊娠组（n=52）。比较两组一般资料及FET前1 d血清D-D、BAFF、E2水平。通过多因素logistic回归分析影响EMs合并不孕患者FET结局的因素，通过受试者工作特征（ROC）曲线分析血清D-D、BAFF、E2水平对EMs合并不孕患者FET后未妊娠的预测效能。结果 未妊娠组血清D-D、BAFF、E2水平显著高于妊娠组（P<0.05）。多因素logistic回归分析结果显示，较高的血清D-D［OR（95%CI）=1.346（1.056～1.716）］、BAFF［OR（95%CI）=1.439（1.027～2.016）］、E2［OR（95%CI）=1.652（1.121～2.435）］水平是EMs合并不孕患者FET后未妊娠的独立危险因素（P<0.05）。ROC曲线分析结果显示，血清D-D、BAFF、E2水平均可有效预测EMs合并不孕患者FET后未妊娠（P<0.05），且三指标联合的预测效能显著优于单一指标（Z三指标联合-D-D=2.875，P=0.004；Z三指标联合-BAFF=3.205，P=0.001；Z三指标联合-E2=3.791，P<0.001）。结论 EMs合并不孕患者血清D-D、BAFF、E2水平升高是FET失败的危险因素，三指标联合检测有助于及早发现高危患者并予以积极干预，提高FET成功率。 |
| 关键词: 子宫内膜异位症 冻融胚胎移植 不孕症 D-二聚体 B淋巴细胞活化因子 雌二醇 |
| DOI：10.3969/j.issn.1674-3806.2026.01.08 |
| 分类号:R 711.6 |
| 基金项目:河北省医学科学研究重点课题计划项目（编号：20221767） |
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| Study on the association of serum D-dimer, BAFF and E2 levels with outcomes of frozen-thawed embryo transfer in patients with endometriosis complicated with infertility |
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FENG Chengwen, FAN Yanling, LIU Baolian
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Department of Reproductive Genetics, Tangshan Maternal and Children Health Hospital, Tangshan 063000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the association of serum D-dimer(D-D), B cell activating factor(BAFF) and estradiol(E2) levels with outcomes of frozen-thawed embryo transfer(FET) in patients with endometriosis(EMs) complicated with infertility. Methods A total of 116 patients with EMs complicated with infertility who were admitted to Department of Reproductive Genetics, Tangshan Maternal and Children Health Hospital from August 2022 to August 2024 were recruited. The patients were divided into pregnancy group(n=64) and non-pregnancy group(n=52) according to their FET outcomes. The general data and the levels of serum D-D, BAFF and E2 on the first day before performing FET were compared between the two groups. Multivariate logistic regression was used to analyze the factors influencing the FET outcomes of the patients with EMs complicated with infertility. The efficacy of serum D-D, BAFF and E2 levels in predicting failure to conceive in the patients with EMs complicated with infertility after receiving FET was analyzed by using receiver operating characteristic(ROC) curve. Results The levels of serum D-D, BAFF and E2 in the non-pregnancy group were significantly higher than those in the pregnancy group(P<0.05). The results of multivariate logistic regression analysis showed that higher levels of serum D-D［OR(95%CI)=1.346(1.056-1.716)］, BAFF［OR(95%CI)=1.439(1.027-2.016)］ and E2［OR(95%CI)=1.652(1.121-2.435)］ were independent risk factors for failure to conceive in the patients with EMs complicated with infertility after receiving FET(P<0.05). The results of ROC curve analysis showed that the levels of serum D-D, BAFF and E2 could effectively predict failure to conceive in the patients with EMs complicated with infertility after receiving FET(P<0.05), and the predictive efficacy of the combination of the three indicators was significantly better than that of a single indicator(Zcombination of the three indicators-D-D=2.875, P=0.004; Zcombination of the three indicators-BAFF=3.205, P=0.001; Zcombination of the three indicators-E2=3.791, P<0.001). Conclusion The elevated levels of serum D-D, BAFF and E2 are risk factors for FET failure in the patients with EMs complicated with infertility. The combined detection of the three indicators is helpful for the early identification of high-risk patients and active intervention, thereby improving the success rate of FET. |
| Key words: Endometriosis(EMs) Frozen-thawed embryo transfer(FET) Infertility D-dimer(D-D) B cell activating factor(BAFF) Estradiol(E2) |
