血清β-HCG、P及阴道超声评估在未破裂宫外孕诊断中的应用  

Evaluation of serum β-HCG,progesterone and vaginal ultrasound in the diagnosis and treatment of unruptured ectopic pregnancy

作　　者：颜雪萍 田圆 吴青京 YAN Xueping;TIAN Yuan;WU Qingjing(Department of ultrasound,Hainan women and children medical center,Haikou,Hainan,China,570206;Department of Gynecology,Hainan women and children medical center,Haikou Hainan,China,570206)

机构地区：[1]海南省妇女儿童医学中心超声科,海南海口570206 [2]海南省妇女儿童医学中心妇科,海南海口570206

出　　处：《分子诊断与治疗杂志》2020年第3期353-357,共5页Journal of Molecular Diagnostics and Therapy

基　　金：海口市重点科技计划项目(2017 1246)。

摘　　要：目的探究血清β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)监测及阴道超声量化评估在未破裂宫外孕诊断及疗效预测中的应用。方法选取2017年10月至2019年12月本院未破裂宫外孕女性62例设为研究组,选择正常妊娠女性62例为对照组。入院后两组均实施超声检查,抽取血液样本测定血清β-HCG、P水平,并给予研究组对症治疗。比较研究组与对照组、研究组不同疗效患者超声参数[阻力指数(RI)、搏动指数(PI)]及血清β-HCG、P水平,分析超声参数及血清β-HCG、P与未破裂宫外孕的相关性。结果研究组PI、RI高于对照组,血清β-HCG、P水平低于对照组(P<0.05);PI、RI、血清β-HCG、P水平与未破裂宫外孕间存在显著关联性(P<0.05);PI、RI、血清β-HCG、P联合诊断未破裂宫外孕的曲线下面积(AUC)为0.893,优于各指标单独诊断,联合诊断的最佳敏感度为82.26%,特异度为79.03%;治疗有效患者PI、RI低于无效患者,血清β-HCG、P水平高于无效患者(P<0.05);PI、RI、血清β-HCG、P中,PI预测未破裂宫外孕疗效的AUC最大,为0.809,最佳预测敏感度为70.00%、特异度为90.38%。结论破裂宫外孕患者血清β-HCG、P水平明显低于正常孕妇,超声检查包块血流参数异常增高,联合血清β-HCG、P及阴道超声量化评估在未破裂宫外孕诊断及疗效评估方面具有较高价值,可为临床诊断未破裂宫外孕提供重要参考。Objective To explore the application of serumβ-human chorionic gonadotropin(β-HCG),progesterone(P) monitoring and vaginal ultrasound quantitative evaluation in the diagnosis and treatment of unruptured ectopic pregnancy. Methods From October 2017 to December 2019,62 women with unruptured ectopic pregnancy in our hospital were selected as the study group,and 62 normal pregnant women were selected as the control group. After admission,both groups underwent ultrasound examination,blood samples were taken to determine serumβ-HCG and P levels,and symptomatic treatment was given to the study group. Compared the ultrasound parameters[resistance index(RI),pulsation index(PI)]and serumβ-HCG,P levels of patients in the study group with the control group and patients with different curative effects in the study group,explored the relationship between ultrasound parameters and serumβ-HCG,P and unruptured ectopic pregnancy,and their diagnostic efficacy in the diagnosis of unruptured ectopic pregnancy. Results The PI and RI in the study group were higher than those in the control group,and the levels of serumβ-HCG and P were lower than those of the control group(P<0.05). There were significant correlations between PI,RI,serumβ-HCG,P levels and unruptured ectopic pregnancy(P<0.05). The area under the curve(AUC)of PI,RI,serumβ-HCG,and P in the diagnosis of unruptured ectopic pregnancy was 0.893,which was greater than the individual diagnosis of the indicators,the best sensitivity of the combined diagnosis was 82.26% and the specificity was 79.03%. The PI and RI of treatment-effective patients were lower than those of ineffective patients,and the serumβ-HCG and P levels were higher than those of ineffective patients(P<0.05). Among PI,RI,serumβ-HCG,and P,PI had the largest AUC for predicting the efficacy of unruptured ectopic pregnancy,0.809,with the best predictive sensitivity of 70.00% and specificity of 90.38%. Conclusion The serumβ-HCG and P levels of patients with unruptured ectopic pregnancy are significantly lowe

关 键 词：未破裂宫外孕 Β-人绒毛膜促性腺激素 孕酮 阴道超声 诊断 疗效 

分 类 号：R714.22[医药卫生—妇产科学]