子宫内膜异位症患者血浆血管性血友病因子裂解蛋白酶水平与病情严重程度和预后的相关性

doi:10.3969/j.issn.1006-5725.2025.02.013

Abstract

Abstract:

Objective To investigate the relationship between plasma von willebrand factory-lytic protease （ADAMTS13） level and the severity of the disease and its prognostic value in patients with endometriosis （EMS）. Methods 130 patients with EMS treated in the hospital from January 2019 to December 2022 were retrospectively selected. Plasma ADAMTS13 level was detected by enzyme-linked immunosorbent assay （ELISA）， and its correlation with American Fertility Society （r-AFS） stage and endometriosis Health Status Scale （EHP-30） score was analyzed. The 1-year prognosis was recorded， and the risk factors of poor prognosis were analyzed by logistic regression. Receiver operating characteristic curve （ROC） was plotted to evaluate the predictive value of plasma ADAMTS13 levels in patients with EMS. Results The plasma ADAMTS13 level of EMS patients decreased significantly with the increase of r-AFS stage， and was negatively correlated with the score of EHP-30 （P < 0.001）. Multiple factors showed that low plasma ADAMTS13 level， bilateral location of pelvic lesions and high r-AFS stage were independent risk factors for poor prognosis （all P < 0.05）. ROC analysis showed that the area under the curve （AUC） of plasma ADAMTS13 was 0.889 （cut-off point 13.315， sensitivity 0.931， specificity 0.690）. Conclusion Plasma ADAMTS13 level is negatively correlated with the severity of EMS， and is an independent risk factor for poor prognosis of EMS patients， and has a certain predictive value for prognosis of EMS patients.

Key words: endometriosis, plasma ADAMTS13 level, r-AFS staging, prognosis

CLC Number:

R711.71

Ke XU,Mingzhe ZHANG,Mingyang WANG,Song. LIU. Correlation between plasma ADAMTS13 level， disease severity and prognosis in patients with endometriosis[J]. The Journal of Practical Medicine, 2025, 41(2): 238-243.

Figures/Tables 7

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References 26

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项目	例数	血浆ADAMTS13水平/（ng/mL）	EHP-30评分/分
Ⅰ期	42	20.80 ± 3.75	17.33 ± 4.97
Ⅱ期	31	17.34 ± 2.06	24.58 ± 6.65
Ⅲ期	34	14.66 ± 1.49	30.12 ± 6.70
Ⅳ期	23	10.38 ± 1.87	31.65 ± 7.40
F值	-	87.297	37.137
P值	-	< 0.001	< 0.001

项目	复发组（n = 29）	未复发组（n = 101）	t/χ²值	P值
年龄/岁	34.52 ± 4.65	32.84 ± 4.66	1.709	0.090
BMI/（kg/m²）	23.27 ± 2.58	24.03 ± 2.63	-1.388	0.167
病程/月	7.59 ± 2.53	7.06 ± 2.42	1.023	0.308
孕次/次	2.00 ± 0.60	1.76 ± 0.65	1.850	0.070
产次/次	1.48 ± 0.78	1.38 ± 0.77	0.652	0.515
痛经史/［例（%）］
有	15（51.72）	38（37.62）	1.855	0.173
无	14（48.28）	63（62.38）
人工流产史/［例（%）］
有	8（27.59）	21（20.79）	0.600	0.439
无	21（72.41）	80（79.21）
盆腔手术史/［例（%）］
有	6（20.69）	20（19.80）	0.011	0.916
无	23（79.31）	81（80.20）
合并宫颈炎/［例（%）］
有	9（31.03）	26（25.74）	0.321	0.571
无	20（68.97）	75（74.26）
合并盆腔炎/［例（%）］
有	6（20.69）	14（13.86）	0.807	0.369
无	23（79.31）	87（86.14）
盆腔病变位置/［例（%）］
单侧	14（48.28）	76（75.25）	13.593	< 0.001
双侧	15（51.72）	25（24.75）
疾病类型/［例（%）］
卵巢型	22（75.86）	77（76.24）	0.831	0.842
腹膜型	3（10.34）	9（8.91）
深部浸润型	2（6.90）	11（10.89）
其他部位型	2（6.90）	4（3.96）
r-AFS分期/［例（%）］
Ⅰ期	1（3.45）	41（40.59）	52.467	< 0.001
Ⅱ期	1（3.45）	30（29.71）
Ⅲ期	10（34.48）	24（23.76）
Ⅳ期	17（58.62）	6（5.94）
血浆ADAMTS13水平/（ng/mL）	11.79 ± 3.30	17.89 ± 3.86	-7.737	< 0.001

可疑影响因素	赋值
血浆ADAMTS13水平	连续变量，直接纳入
盆腔病变位置	1=单侧，2=双侧
r-AFS分期	1=Ⅰ期，2=Ⅱ期，3=Ⅲ期，4=Ⅳ期

变量	B	SE	Wald	P值	OR（95%CI）
血浆ADAMTS13水平	-0.436	0.195	5.018	0.025	0.647（0.441 ~ 0.947）
盆腔病变位置	2.959	0.814	13.211	< 0.001	19.281（3.910 ~ 95.091）
r-AFS分期	1.194	0.587	4.145	0.042	3.302（1.046 ~ 10.428）

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Correlation between plasma ADAMTS13 level， disease severity and prognosis in patients with endometriosis

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