血浆肾上腺髓质素水平对早期异位妊娠的诊断价值  

Value of plasma adrenomedullin level for diagnosis of early ectopic pregnancy

作　　者：严琦 陆琦[2] 王玉东[2] 赵文霞 

机构地区：[1]上海市虹口区江湾医院妇产科,上海200434 [2]上海交通大学医学院附属国际和平妇幼保健院妇产科,上海200030

出　　处：《上海交通大学学报（医学版）》2015年第7期995-998,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市虹口区优青培养项目(2013);上海交通大学"新百人计划"研究项目(XBR2013097);上海市卫生局基金(20124027);上海市市级医院适宜技术(SHDC12014208);上海市科委医学引导项目(15411961100)~~

摘　　要：目的探讨血浆中肾上腺髓质素（ADM）在早期异位妊娠中变化情况,研究其对异位妊娠早期诊断的价值。方法选取2014年3月—12月在上海交通大学医学院附属国际和平妇幼保健院及上海市虹口区江湾医院收治的50例停经5-7周的异位妊娠患者为研究对象,另选取140名正常宫内妊娠者为正常对照组,绘制散点图,观察ADM水平与停经周数的相关性;利用受试者工作特征（ROC）曲线分析ADM的临界点。结果 1140例正常对照组血浆ADM水平总体趋势是随停经周数的增加而增加,相关系数r为0.283（P〈0.05）。250例异位妊娠组血浆ADM水平一直处于低值状态,随着停经周数的增加变化不明显,r值为0.186（P〉0.05）。3异位妊娠组停经7周的中位数倍数明显低于正常对照组（P〈0.05）。4应用ROC曲线分析ADM诊断异位妊娠的临界值（P〉0.05）。结论早期异位妊娠者血浆ADM水平处于低值状态,随停经周数变化不明显,但作为异位妊娠早期诊断的指标无统计学意义（P〉0.05）。Objective To investigate the changes of plasma adrenomedullin（ADM） of patients with early ectopic pregnancy and the value for early diagnose of ectopic pregnancy.Methods A total of 50 patients with ectopic pregnancy who had menopause for 5-7 weeks were selected as subjects and 140 women with normal singleton pregnancy were selected as controls.All patients were admitted in International Peace Maternity and Child Health Hospital affiliated to Shanghai Jiao Tong University School of Medicine and Jiangwan Hospital of Shanghai Hongkou District from March to December 2014.The scatter diagram was plotted and the correlation between ADM level and weeks of menopause were observed.Critical points of ADM were analyzed by receiver operator characteristic（ROC） curves.Results ①Being increase with menopause weeks was the overall trend of plasmatic ADM level of 140 controls and the correlation coefficient r was 0.283（P〈0.05）.②The plasmatic ADM levels of 50 patients with ectopic pregnancy were always low,which did not change a lot with the increase of menopause weeks.The correlation coefficient was 0.186（P 〉0.05）.③The multiple of median of 7menopause weeks of patients was obviously lower than that of controls（P〈0.05）.④ROC curves was used to analyze critical points of ADM for the diagnosis of ectopic pregnancy（P〉0.05）.Conclusion The ADM levels of patients with early ectopic pregnancy were low and did not change significantly with the increase of menopause weeks,but using it as an index of early diagnosis of ectopic pregnancy is not statistically significant（P〉0.05）.

关 键 词：肾上腺髓质素 妊娠早期 异位妊娠 

分 类 号：R714.22[医药卫生—妇产科学]