阴道超声结合血清孕酮及β-HCG联合检测早期先兆流产的临床价值  

The clinical value of combination detection of transvaginal color Doppler ultrasound and serum levels of progesterone and β-HCG in diagnosis of threatened abortion

作　　者：张婷婷 朱文娜 曹娜[3] 徐俊荣[4] 尹晓燕[1] ZHANG Tingting;ZHU Wenna;CAO Na(Deparment of UItrasonic Diagnosis,The Fourth Hospital of Hengshui City,Hebei,Hengshui 053000,China)

机构地区：[1]河北省衡水市第四人民医院超声诊断科,053000 [2]河北省阜城县人民医院超声诊断科 [3]河北省衡水市第四人民医院检验科,053000 [4]河北省衡水市第四人民医院妇产科,053000

出　　处：《河北医药》2018年第7期969-973,共5页Hebei Medical Journal

基　　金：衡水市重点研发技术项目(编号:2017014019Z)

摘　　要：目的探讨经阴道彩色多普勒超声结合血清孕酮及β-HCG联合检测早期先兆流产中的临床价值。方法选取2015年1月至2017年5月就诊的患者218例,其中先兆流产组68例,难免流产组30例,正常妊娠组120例。所有对象行经阴道彩色多普勒超声检查,观察比较妊娠黄体的内部回声情况及不同时间段绒毛间隙血流变化,同时检测血清孕酮和β-HCG水平,计算各指标对流产的诊断灵敏度、特异度及准确率,对3组结果进行分析。结果与流产组比较,正常妊娠组和先兆流产组在绒毛间隙血流的收缩期峰值流速(VPS)、收缩期上升支加速度时间(ACT)及阻力指数(RI)差异均有统计学意义(P<0.05),正常妊娠组与先兆流产2组差异无统计学意义(P>0.05)。血清孕酮和β-HCG水平在正常妊娠组显著高于先兆流产组和流产组,且先兆流产组显著高于流产组,差异有统计学意义(P<0.05)。单项检测血清孕酮对流产诊断的灵敏度、特异度及准确度分别为77.9%、75.7%及73.7%;单项检测β-HCG对流产诊断的灵敏度、特异度及准确度分别为66.1%、71.5%及64.9%,二者联合检测对流产诊断的灵敏度、特异度及准确度分别为94.6%、89.7%及94.5%。超声检测妊娠黄体回声,正常妊娠组不均质低回声型约占16.7%,明显低于先兆流产组(35.3%)和流产组(46.9%),3组比较差异有统计学意义(P<0.05)。结论经阴道彩色多普勒超声联合血清孕酮及β-HCG更具优越性,可更准确地判断先兆流产。Objective To investigate the clinical value of combination detection of transvaginal color Doppler ultrasound and serum levels of progesterone andβ-HCG in diagnosis of threatened abortion.Methods A total of 218 patients who were diagnosed and treated in our hospital from January 2015 to May 2017 were divided into threatened abortion group(n=68),inevitable abortion group(n=30),normal pregnancy group(n=120).All the subjects were examined by transvaginal color Doppler ultrasound to observe the changes of internal echo of corpus luteum of pregnancy and intervillous space blood flow,at the same time,the serum levels progesterone andβ-HCG were detected,moreover the diagnostic sensitivity,specificity and accuracy were observed and compared among different detection methods.Results There were significant differences in volume peak systolic(VPS)in intervillous space blood flow,systolic upstroke accelerate time(ACT)and resistance index(RI)between abortion group and normal pregnancy group,threatened abortion group(P<0.05),however,there were no significant differences between normal pregnancy group and threatened abortion group(P>0.05).In addition the serum levels of progesterone andβ-HCG in normal pregnancy group were significantly higher than those in threatened abortion group and inevitable abortion group,moreover,which in threatened abortion group were significantly higher than those in inevitable abortion group(P<0.05).The sensitivity,specificity and accuracy of single detection of serum progesterone in diagnosis of abortion were 77.9%,75.7%and 73.7%,respectively,which by single detection ofβ-HCG were 66.1%,71.5%and 64.9%,respectively,which by combination detection were 94.6%89.7%,and 94.5%,respectively.The results of ultrasound examination of the corpus luteum echo showed that heterogeneity low level echo accounted for 16.7%in normal pregnancy group,which was significantly lower than that(35.3%)in threatened abortion group and that(46.9%)in inevitable abortion group,there were significant differences among the thre

关 键 词：经阴超声 孕酮 血清Β-HCG 先兆流产 

分 类 号：R714.21[医药卫生—妇产科学]