目的:探讨子宫动脉血流参数联合血小板聚集功能预测不明原因复发性流产(URSA)的价值。方法:将2021年9月至2023年8月本院收治的94例URSA患者作为URSA组,另外将同期在本院进行产检的110例正常妊娠孕妇作为对照组。URSA患者随访至妊娠28周,根据妊娠结局分为正常妊娠组(n = 25)和流产组(n = 69)。比较2组患者子宫动脉血流参数、血小板聚集率;采用受试者工作特性(ROC)曲线评估子宫动脉血流参数、血小板聚集率对URSA患者妊娠结局的预测价值;采用二分类Logistic逐步回归分析探讨URSA患者妊娠结局的影响因素。结果:在搏动指数(PI)、动脉血流阻力指数(RI)、收缩期/舒张期血流速度比值(S/D)、血小板聚集率指标方面,URSA组相较于对照组更高(P P P Objective: To explore the value of the combination of uterine artery flow parameters and platelet aggregation function in predicting unexplained recurrent abortion (URSA). Methods: 94 patients with URSA from September 2021 to August 2023 were selected as the URSA group, and 110 normal pregnant women who underwent prenatal examination were selected as the control group. The URSA patients were followed up until 28 weeks of gestation and divided into the normal pregnancy group (n = 25) and the abortion group (n = 69) according to the pregnancy outcome. The uterine artery blood flow parameters and platelet aggregation rate were compared between the two groups. The predictive value of the uterine artery flow parameters and platelet aggregation rate for the pregnancy outcomes of URSA patients was evaluated by ROC. Binary Logistic stepwise regression was employed to explore the influencing factors of the pregnancy outcomes of URSA patients. Results: The indexes of the pulse index (PI), the arterial flow resistance index (RI), the systolic/diastolic blood flow velocity ratio (S/D), and the platelet aggregation rate in the URSA group were higher than those in the control group (P P P < 0.05). The ROC curve de
目的原发性乳腺淋巴瘤(primary breast lymphoma,PBL)是一种罕见的血液系统疾病,在临床上常与乳腺恶性肿瘤混淆。本研究分析近5年国内外有关PBL的研究,明确其诊断、治疗以及预后的特点,提高临床工作中对PBL的认识。方法应用PubMed、中国知网以及万方数据库检索系统,以中文关键词“乳腺、淋巴瘤”和英文关键词“breast、lymphoma、diagnosis、treatment”,检索2014-01-2019-08发表的相关文献,共检索中文文献105篇,英文文献289篇。纳入标准:(1)与PBL的诊断、治疗以及预后有关的研究;(2)有特色的个案研究;(3)病例数较多的临床实验。排除标准:(1)非中文核心期刊和英文非SCI收录的文献;(2)作者所属单位为基层医院;(3)结果重复且相对陈旧的临床实验。根据纳入和排除标准,最终38篇文献纳入分析。结果PBL是指在没有先前诊断为乳房外淋巴瘤且同时不存在其他广泛疾病的情况下发生在乳房中的原发性淋巴瘤,其发病率低,容易与乳腺癌混淆。PBL女性的发病率高,一般以单侧乳房肿块为首发症状;影像学诊断缺乏特异性,细针穿刺及病理学检查为金标准;局部手术可用于病理诊断,化疗联合靶向治疗是目前的主要治疗方式,辅助放疗可以改善PBL患者的预后,降低复发风险,但是对于预防性鞘内注射目前有很大争议;预后与病理类型、临床分期以及是否有结外器官受累有关。结论PBL的发病率低,确诊需要依靠病理学检查,临床中有可疑的淋巴瘤患者应与乳腺癌患者区分,避免误诊。
