经阴道超声检查联合48h血HCG比率对异位妊娠的预测价值  

Predicative value of transvaginal ultrasonography combined with 48 hours blood HCG ratio for detection of ectopic pregnancy

作　　者：易俊秀 华兴[1] 郭燕丽[1] 李锐[1] 

机构地区：[1]第三军医大学西南医院超声科,重庆400038

出　　处：《局解手术学杂志》2017年第2期149-152,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨子宫内膜厚度联合48 h血清人绒毛膜促性腺激素(HCG)比率在异位妊娠中的预测价值。方法选择我院2014年6月至2016年5月门诊及住院患者,根据妊娠结局和术后病理结果,有90例患者被纳入作为研究对象(宫外孕组40例和正常妊娠组50例),通过经阴道超声检查测定子宫内膜厚度,化学发光分析技术检测所有研究对象血HCG浓度并计算48 h血HCG比值;以发生异位妊娠作为终点事件,利用ROC曲线和Logistic回归来分析子宫内膜厚度、48 h血HCG比率以及二者联合使用预测异位妊娠的价值。结果异位妊娠组的子宫内膜厚度和48 h血HCG比率分别是(11.75±3.42)mm和(1.06±0.38)%,低于正常妊娠组的(15.52±3.98)mm和(1.46±0.20)%,差异具有统计学意义(P=0.000)。子宫内膜厚度和48 h血HCG比率的ROC曲线下面积(AUCROC)分别为0.77[95%CI(0.67,0.87)]和0.82[95%CI(0.73,0.91)]。当二者联合使用时,AUCROC上升到0.89[95%CI(0.83,0.95)],差异具有统计学意义(P=0.04)。结论子宫内膜厚度和48 h血HCG比率是异位妊娠的预测因子,二者联合使用能显著提高预测能力,为异位妊娠诊断提供一种新的思路。Objective To explore the predicative value of transvaginal uhrasonography and 48 hours blood HCG ratio for ectopic preg- nancy（EP）. Methods A total of 90 patients in our hospital from June 2014 to May 2016 were selected as the object according to the preg- nancy result and postoperative pathology （40 cases in EP group and 50 cases in control group ）. The endometrial thickness was measured through transvaginal ultrasonography while blood HCG was detected by chemiluminescence technique and 48 hours blood HCG ratio was cal- culated. To evaluate the individual and combined predicative value of endometrial thickness and 48 hours blood HCG ratio for EP, receiver op- erating characteristic curves（ROC） were generated and logistic regression analysis was conducted. Results The endometriam thickness and 48 h blood HCG ratio of EP group were （11.75 ± 3.42）mm and （1.06± 0.38 ）% ,respectively ,which were lower than （15.52±3.98 ）mm and （1.46 ± 0.20 ）% of control group, the differences were statistically significant（ P = 0. 000 ）. The AUCs and their corresponding 95% confidential intervals （CI） were 0.77 [ 95 % CI（ O. 67,0.87 ） ] and 0.82 [ 95 % CI（ O. 73,0.91 ） ], respectively. Combined ROC analysis based on the 2 indexes revealed an elevated AUC of 0.89 [ 95 % CI（ O. 83,0.95 ） ] , the differences were statistically significant （ P = 0.04 ）. Conclu- sion The endometrial thickness and 48 hours blood HCG ratio can be acted as useful predicative biomarkers for detection of EP. A combination of the two indexes could be a useful predicative biomarker for future clinical trials with EP and may act as a suitable add-on biomarker to the panel of methods already existing for EP.

关 键 词：异位妊娠 人绒毛膜促性腺激素 48 h比值 经阴道超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R246.3[医药卫生—诊断学]