联合检测血清血管内皮生长因子和β-HCG对早期异位妊娠的诊断意义  

The Diagnose Value of Combining Determination Vascular Endothelial Growth Factor and β-HCG in Early Nontypical Ectopic Pregnancy

作　　者：徐进 沈杨[2] 

机构地区：[1]南京市雨花医院妇产科,210012 [2]东南大学附属中大医院妇产科

出　　处：《临床输血与检验》2017年第4期375-379,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：江苏省卫生厅青年基金项目(No.Q201305)资助

摘　　要：目的探讨联合检测血清血管内皮生长因子(VEGF)和β-HCG对早期异位妊娠的鉴别诊断价值。方法收集南京市雨花医院140例妊娠患者,其中异位妊娠60例(孕周<7周)作为异位妊娠组,选择同期正常宫内妊娠80例为正常妊娠组。采用ELISA法对两组血清VEGF和β-HCG水平进行测定,根据受试者工作曲线(ROC)计算临床诊断界值,并对结果进行统计分析。结果异位妊娠组中VEGF表达显著高于正常妊娠组,β-HCG表达低于正常妊娠组,差异均有统计学意义(VEGF pg/ml:270.35±111.55 vs.125.94±42.38,P<0.001;β-HCG U/ml:9 790.35±1620.79 vs.12 888.13±2 544.4,P<0.001)。VEGF取202.50pg/ml时,AUC值为0.945,诊断异位妊娠的敏感度、特异度和准确性分别为75.0%、97.5%、90.2%。β-HCG取10 950.30U/ml时,AUC值为0.855,诊断异位妊娠的敏感度、特异度和准确性分别为76.3%、76.7%、83.1.%。二者联合检测的敏感度、特异度和准确性为91.3%、95.0%和85.5%。结论早期异位妊娠时,血清中VEGF显著增高、β-HCG下降,二者对异位妊娠有一定的诊断价值。联合检测VEGF和β-HCG可进一步提高早期异位妊娠诊断敏感度。Objective To determine the level of VEGF and β-HCG in early non-typical ectopic pregnancy （EP） and investigate the combining determination of diagnostic value of VEGF andβ-HCG for EP. Methods 140 pregnancy patients from Nanjing Yuhua hospital were enrolled into this study,of which 60 patients with EP （〈7-week）and 80 patients with intrauterinepregnancy. The VEGF andβ-HCG levels were tested by ELISA,ROC was used to cut-off value and all the Results were analyzed by the statistical method. Results The levels of VEGF in EP was significantly higher than that in intrauterinepregnancy,while β-HCG was significantly lower than that in intrauterinepregnancy（VEGF：270.35±111.55pg/ml vs. 125.94±42.38 pg/ml,P=0.000;β-HCG：9 790.35±1 620.79 vs. 12888.13±2 544.41U/ml,P =0.000）. With a cut-off value of 202.50 pg/ml,the AUC value of VEGF is 0.945. The sensitivity of VEGF testing for diagnosing EP was 75.0%,the specificity was 97.5% and the accuracy was 90.2%.With a cut-off value of 10 950.30 U/ml,the AUC value of VEGF is 0.855. The sensitivity of β-HCG testing for diagnosing EP was 76.3%,the specificity was 76.7%,and the accuracy was 83.1%. The sensitivity of the combined testing was 91.3%,the specificity was 95.0% and the overall accuracy was 85.5%. The sensitivity and the overall accuracy of combined testing were higher than those of β-HCG and ADAM12-S testing single. Conclusion EP presents higher VEGF and lower β-HCG concentration than those with intrauterinepregnancy and determination of VEGF and β-HCG is useful to differentiate EP from intrauterinepregnancy. The combined testing of VEGF and β-HCG can increase the sensitivity of diagnosis of EP.

关 键 词：异位妊娠 血管内皮生长因子 Β-HCG 诊断 

分 类 号：R714.22[医药卫生—妇产科学] R446.11[医药卫生—临床医学]