| 赵思琪,王 焱,张俊俊,咸倩倩,赵 珍.支原体生殖道感染妇女阴道微生态改变对临床转归的影响及XGboost模型构建[J].,2023,(2):324-329 |
| 支原体生殖道感染妇女阴道微生态改变对临床转归的影响及XGboost模型构建 |
| Effect of Vaginal Microecological Changes on the Clinical Outcome in Women with Mycoplasma Genital Tract Infection and Construction of XGboost Model |
| 投稿时间：2022-05-10 修订日期：2022-05-31 |
| DOI：10.13241/j.cnki.pmb.2023.02.023 |
| 中文关键词: 支原体生殖道感染 阴道微生态 临床转归 影响因素 XGboost模型 |
| 英文关键词: Mycoplasma genital tract infection Vaginal microecological Clinical outcome Influencing factors XGboost model |
| 基金项目:河南省科技攻关项目（172102310251） |
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| 中文摘要: |
| 摘要 目的：探讨支原体生殖道感染妇女阴道微生态改变对临床转归的影响，并构建XGboost模型。方法：选取2019年1月~2020年12月于我院妇科门诊确诊的支原体生殖道感染妇女186例。根据治疗后3个月的临床转归分为有效组145例和无效组41例。比较两组患者的临床资料、阴道微生态形态学指标和功能学指标、微生态类型。使用Cox比例风险回归森林图筛选影响支原体生殖道感染妇女临床转归的因素，利用筛选出的影响因素构建XGboost模型并对影响因素按重要度排序，ROC曲线分析XGboost模型对支原体生殖道感染妇女临床转归的预测效能，校准曲线评价XGboost模型的准确度，临床决策曲线评价XGboost模型的有效性。结果：两组患者的流产次数、学历、年龄、避孕方式、生产次数对比有差异（P<0.05）。与有效组相比，无效组患者阴道微生态形态学和功能学各指标异常发生率、阴道微生态失调率明显较高（P<0.05），无效组的需氧型阴道炎（AV）、外阴阴道假丝酵母菌病（VVC）、细菌性阴道病（BV）、BV+VVC、滴虫性阴道炎（TV）、BV中间型+VVC的检出率均明显较高（P<0.05），无效组正常微生态及菌群正常、功能下降所占人数比例均明显更低，差异均有统计学意义（P<0.05）。年龄<25岁、高中以下学历、流产次数>1次、生产产次≥3次以及阴道微生态失调是影响支原体生殖道感染转归的重要因素（P<0.05）。构建的XGboost模型具有较高的预测效能，准确度和有效性均较高。结论：年龄、学历、流产次数、生产次数以及阴道微生态失衡是影响支原体生殖道感染临床转归的重要因素，本研究构建的XGboost模型具有较好的预测效能。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of vaginal microecological changes on the clinical outcome in women with Mycoplasma genital tract infection, and to construct XGboost model. Methods: 186 women with Mycoplasma genital tract infection who were diagnosed in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. According to the clinical outcome 3 months after treatment, they were divided into effective group with 145 cases and ineffective group with 41 cases. The clinical data, vaginal microecological morphological and functional indexes and microecological types of the two groups were compared. The Cox proportional hazards regression forest map was used to screen the factors affecting the clinical outcome of women with Mycoplasma genital tract infection. The selected influencing factors were used to construct the XGboost model and rank the influencing factors according to the importance. The ROC curve was used to analyze the prediction efficiency of XGboost model on the clinical outcome of women with Mycoplasma genital tract infection, the calibration curve was used to evaluate the accuracy of XGboost model, and the clinical decision curve was used to evaluate the effectiveness of XGboost model. Results: There were significant differences in the number of abortions, educational background, age, contraceptive methods and the number of births between the two groups (P<0.05). Compared with the effective group, the incidence of abnormal vaginal microecological morphology and function indexes and the rate of vaginal microecological imbalance in the ineffective group were significantly higher(P<0.05). The detection rates of aerobic vaginitis (AV), vulvovaginal candidiasis (VVC), bacterial vaginosis (BV), BV combined with VVC, trichomonal vaginitis (TV), BV intermediate combined with VVC in the ineffective group were significantly higher(P<0.05). The proportion of normal microecology, normal flora and functional decline in the ineffective group was significantly lower, and the differences were statistically significant(P<0.05). Age < 25 years old, educational background below high school, number of abortions > 1, number of births ≥ 3 and vaginal microecological imbalance were important factors affecting the prognosis of Mycoplasma genital tract infection (P<0.05). The XGboost model has high prediction efficiency, high accuracy and effectiveness. Conclusion: Age, educational background, number of abortions, number of births and vaginal microecological imbalance are important factors affecting the clinical outcome of Mycoplasma genital tract infection. The XGboost model constructed in this study has good prediction efficiency. |
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