产前超声征象评分联合甲胎蛋白检测对前置胎盘合并胎盘植入的诊断价值探究  

The diagnostic value of prenatal ultrasonic signs score combined with alpha fetoprotein in placenta previa complicated with placenta increta

作　　者：刘学梅[1] 韩秀平[2] 张正良[3] 

机构地区：[1]延安大学附属医院超声医学科,陕西延安716000 [2]延安大学附属医院综合内科,陕西延安716000 [3]西安交通大学第二附属医院西北医院急诊科,西安710004

出　　处：《中国医学前沿杂志（电子版）》2016年第10期45-48,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：陕西省社会发展科技攻关项目(2016SF-047)

摘　　要：目的 探究产前超声征象评分联合甲胎蛋白（alpha fetoprotein,AFP）检测对前置胎盘合并胎盘植入的诊断价值,为前置胎盘合并胎盘植入的早期诊断提供参考依据。方法 回顾性分析本院2012年3月至2016年3月收治的291例产妇的临床资料。按照其产检及剖宫产术后病理结果,将前置胎盘合并胎盘植入者纳入植入组（89例）,前置胎盘未合并胎盘植入者纳入未植入组（106例）,未合并前置胎盘、胎盘植入但剖宫产次数≥1次、孕次≥3次者纳入对照组（96例）。比较各组产妇产前超声征象评分和孕晚期血清AFP水平,分析其对前置胎盘合并胎盘植入的诊断价值。结果 植入组产妇产前超声征象评分和孕晚期血清AFP水平均高于未植入组和对照组（P〈0.05）,未植入组和对照组产妇产前超声征象评分和孕晚期血清AFP水平比较差异均无显著性（P〉0.05）。产前超声征象评分联合AFP检测诊断前置胎盘合并胎盘植入的灵敏度为97.67%（84/86）,特异度为97.56%（200/205）。接受者操作特征曲线（ROC曲线）提示,产前超声征象评分联合AFP检测诊断前置胎盘合并胎盘植入的曲线下面积（AUC）为0.891,95%CI为0.871~0.926（P〈0.05）。结论 产前超声征象评分联合AFP检测对前置胎盘合并胎盘植入的诊断具有较高的灵敏度和特异度,可为临床诊治提供参考依据。Objective To explore the diagnostic value of prenatal ultrasonic signs score combined with alpha fetoprotein （AFP） in placema previa complicated with placenta increta, and to provide the early diagnosis reference of placenta previa complicated with placenta increta. Method Retrospectively analyzed the clinical data of 291 cases of maternal in our hospital from March 2012 to March 2016, in accordance with the examination and caesarean birth operation pathological results, placenta previa complicated with placenta increta into implantation group （89 cases）, the placenta previa without placenta increta into the non implanted group （106 cases）, neither placenta previa nor placenta increta but took cesarean section equal or more than once, gravidity times was more than or equal to 3 times were included in control group （96 cases）. Compared each group with its late pregnancy ultrasonic signs score, the level of peripheral blood AFP, diagnostic value of the placenta previa combined with placenta increta was analyzed. Result Prenatal ultrasonic sign score and serum AFP level in late pregnancy of implantation group were higher than non implantation group and control group （P ~ 0.05）, there were no significant differences between non implanted group and control group in prenatal ultrasound sign score and serum AFP level in late pregnancy （P 〉 0.05）. The sensitivity of prenatal ultrasonic signs score combined with AFP detection in the diagnosis of placenta previa and placenta increta was 97.67% （84/86）, and the specificity was 97.56% （200/205）. The ROC showed that the AUC was 0.891, 95%CIwas 0.871 - 0.926 in the diagnosis of placenta previa and placenta increta by prenatal ultrasonic sign score combined with the serum AFP level detection （P 〈 0.05）. Conclusion Prenatal ultrasonic sign score combined with AFP level detection has a high sensitivity and specificity in the diagnosis of placenta previa and placenta increta, and its good value of diagnosis can provide a reliable reference f

关 键 词：超声征象评分 甲胎蛋白 前置胎盘 胎盘植入 产前诊断 

分 类 号：R714.2[医药卫生—妇产科学]