彩超联合甲胎蛋白在孕晚期预测凶险性前置胎盘合并胎盘植入的应用分析  

Application of color Doppler ultrasonography combined with alpha fetal protein in prediction of placenta previa complicated with placenta accrete in the third trimester

作　　者：倪雪梅[1] 赖微[2] 朱巧英[1] 成春岚 叶成燕[1] 

机构地区：[1]四川省妇幼保健院检验科,四川成都610015 [2]四川省妇幼保健院妇产科,四川成都610015

出　　处：《中国计划生育和妇产科》2017年第8期53-56,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨彩超联合甲胎蛋白(alpha fetal protein,AFP)在孕晚期预测凶险性前置胎盘合并胎盘植入的应用价值。方法选取2012年10月至2015年11月在四川省妇幼保健院确诊的凶险性前置胎盘孕晚期孕妇78例作为研究对象,分为胎盘植入组36例,非胎盘植入组42例;选取有剖宫产史但此次妊娠胎盘正常的孕妇30例作为对照组,对比3组孕妇血清AFP水平;对比分析彩超、AFP及二者联合对凶险性前置胎盘合并胎盘植入的诊断价值。结果植入组AFP水平显著高于非植入组与对照组,差异有统计学意义(P<0.05);非植入组与对照组的AFP水平比较差异无统计学意义(P>0.05);经ROC曲线分析,AFP的临界值为294.53 ng/mL;彩超的敏感度、特异度、阳性预测值、阴性预测值分别为67.57%、73.17%、69.44%、71.43%;AFP的为56.41%、64.10%、61.11%、59.52%;二者联合为82.05%、83.33%、88.89%、89.74%;二者联合的符合率(85.90%)显著高于彩超(70.51%)与AFP(60.26%),差异有统计学意义(P<0.05);经ROC曲线分析,二者联合的曲线下面积(0.90)高于彩超(0.78)及AFP(0.65)。结论彩超联合AFP在孕晚期凶险性前置胎盘合并胎盘植入具有较高的诊断价值。ObjeCtive To evaluate the value of color Doppler ultrasonography combined with alpha fetal protein （AFP） in prediction of placenta previa complicated with placenta acereta in the third trimester. Methods 78 cases of pregnant women with placenta previa in the third trimester in Sichuan Maternal and Child Health Care Hospital from October 2012 to November 2015 were selected and divided into placenta accreta group（36 cases） and non -placenta accreta group（42 cases）. 30 cases of pregnant women with cesarean section and normal placenta were selected as control group. Serum AFP levels in the three groups were compared. To evaluate the value of color Doppler ultrasonography combined with alpha - fetoprotein in prediction of placenta previa complicated with placenta accrete. Results The level of AFP in placenta aeereta group was significantly higher than that in non - placenta accreta group and control group, the differences were statistically significant（ P 〈 0. 05 ） ; there was no significant difference in AFP level between non - implanted group and control group （ P 〉 0. 05）. By the analysis of ROC curve, the critical value of AFP was 294. 53 ng/mL. The sensitivity, specificity, positive predictive value and negative predictive value of color Doppler ultrasound were 67.57 % , 73. 17 % , 69.44 %, 71.43 % ,and those of AFP were 56.41%, 64. 10 %, 61.11%, 59. 52 %. The combination of the two were 82. 05 %, 83.33 %, 88. 89 %, 89. 74 %. The coincidence rate of the combination of the two （85.90 % ） was significantly higher than that of ultrasound （70. 51% ） and AFP （60. 26 % ）. The differences were statistically significant （P 〈 0. 05）. By the analysis of ROC curve, the area under the curve of two combined（0.90） was higher than that of AFP （0. 78 ） and ultrasound （0. 65 ）. Conclusion Color Doppler ultrasound combined with AFP in the third trimester has high diagnostic value of placenta previa complicated with placenta accreta.

关 键 词：彩超 AFP 孕晚期 凶险性前置胎盘 胎盘植入 

分 类 号：R714.56[医药卫生—妇产科学]