妊娠早期血清雌二醇水平预测宫内妊娠结局的临床价值研究  

Clinical Value of Serum Estradiol Level in Predicting Early Intrauterine Pregnancy Outcome

作　　者：易旺云[1] 

机构地区：[1]广东医学院附属陈星海医院妇产科,广东省中山市528415

出　　处：《中国全科医学》2014年第18期2130-2132,共3页Chinese General Practice

摘　　要：目的：应用受试者工作特征（ ROC）曲线评价血清雌二醇在妊娠早期预测宫内妊娠结局的临床价值。方法选择2013年1-5月在广东医学院附属陈星海医院妇产科就诊的早期宫内单胎（4-6周）孕妇114例，根据最后妊娠结局分为正常妊娠组52例和稽留流产组62例，检测血清雌二醇水平，应用ROC曲线对雌二醇水平进行统计学分析。结果正常妊娠组血清雌二醇水平高于稽留流产组〔704（482）μg/L与192（250）μg/L，U ＝442.5，P ＝0.000〕。血清雌二醇水平判断正常妊娠与稽留流产的ROC曲线下面积为0.863，最佳临界值为242μg/L，此时敏感度为0.942、特异度为0.645、阳性预测值为0.690、阴性预测值为0.930、阳性似然比为2.654、阴性似然比为0.089、漏诊率为0.058。结论血清雌二醇水平可用于预测早期宫内妊娠的结局，其最佳临界值为242μg/L，具有较高的阴性预测值，可有效地预测稽留流产。Objective To evaluate the clinical value of serum estradiol level in predicting pregnancy outcome during early intrauterine pregnancy by applying receiver operating characteristic（ROC）curve. Methods A total of 114 women with early monovular pregnancy（ four to six weeks）admitted to Chen Xinghai Hospital Affiliated to Guangdong Medical College from January to May 2013 were selected and divided into normal pregnancy groups（n=52）and missed abortion groups（n=62）according to pregnancy outcome,and their serum estradiol levels were assayed and compared between the two groups,and then the statistics were analyzed by ROC curve. Results The serum level of estradiol in normal pregnancy group〔704（482）μg/L〕was significantly higher than that in missed abortion group〔192（250）μg/L〕,and the difference was statistically significant（U=442. 5,P=0. 000）. The area under the ROC curve of serum estradiol in judging normal intrauterine pregnancy and missed abortion was 0. 863. The best threshold was 242 μg/L. In this case,the sensitivity,specificity,PPV,NPV,＋LR and -LR were 0. 942,0. 645,0. 690,0. 930,2. 654 and 0. 089 respectively,and the omitting rate was 0. 058. Conclusion The level of ser-um estradiol can be used to predict pregnancy outcome during early intrauterine pregnancy. The best threshold is 242 μg/L. It has high negative predictive value and could be effectively used to predict missed abortion.

关 键 词：ROC曲线 雌二醇 预测 妊娠初期 妊娠结局 

分 类 号：R271.41[医药卫生—中医妇科学]