彩色多普勒超声联合血清学标志物对胎盘植入的诊断价值  

Value of color Doppler ultrasound combined with serological markers in diagnosis of placental implantation

作　　者：周冰峰[1] 侯敬[1] 付久园[1] 阚长利[1] ZHOU Bingfeng;HOU Jing;FU Jiuyuan;KAN Changli(Department of Obstetrics,South Hospital of Chengde Medical College,Chengde,Hebei 067000,China)

机构地区：[1]承德医学院附属医院南院产科,河北承德067000

出　　处：《国际检验医学杂志》2020年第11期1326-1328,1332,共4页International Journal of Laboratory Medicine

基　　金：河北省承德市科学技术研究与发展计划项目(201804A018)。

摘　　要：目的探讨彩色多普勒超声联合血清学标志物甲胎蛋白(AFP)、肌酸激酶(CK)、血管内皮生长因子(VEGF)、可溶性血管内皮生长因子受体1(sFlt-1)对胎盘植入的诊断价值。方法将在该院治疗的90例胎盘植入者根据病理学结果分为胎盘植入组36例和非胎盘植入组54例。另选择31例查体健康的孕妇作为对照组。所有孕妇产前均接受彩色多普勒超声检查,并采用速率法测定血清CK,采用酶联免疫吸附法检测血清AFP、VEGF、sFlt-1水平。分析彩色多普勒超声、AFP、CK、VEGF、sFlt-1及4项指标联合对胎盘植入的产前诊断价值。结果胎盘植入组血清AFP、CK、VEGF显著高于非胎盘植入组和对照组,差异有统计学意义(P<0.05),sFlt-1低于非胎盘植入组和对照组,差异有统计学意义(P<0.05)。非胎盘植入组和对照组血清AFP、CK、VEGF和sFlt-1比较,差异无统计学意义(P>0.05);彩色多普勒超声诊断胎盘植入的一致性较病理学差(P>0.05);彩色多普勒超声、AFP、CK、VEGF和sFlt-1诊断胎盘植入的灵敏度分别为30.56%、80.03%、85.93%、86.72%、84.38%,特异度分别为96.30%、87.42%、89.37%、91.05%、88.02%。而彩色多普勒超声联合AFP、CK、VEGF和sFlt-1诊断胎盘植入的灵敏度可提高到94.31%,特异度为84.07%。结论血清AFP、CK、VEGF和sFlt-1联合彩色多普勒超声能有效提高对胎盘植入的诊断,具有临床指导意义。Objective To investigate the value of color Doppler ultrasound combined with serum markers alpha-fetoprotein(AFP),creatine kinase(CK),vascular endothelial growth factor(VEGF),and soluble vascular endothelial growth factor receptor 1(sFlt-1)in the diagnosis of placental implantation.Methods A total of 90 patients with placenta implanted in this hospital were randomly divided into placenta implantation(n=36)and non-implantation group(n=54).Another 31 healthy pregnant women were selected as the control group.All pregnant women received color Doppler ultrasound before delivery,and CK was measured by rate method.The levels of AFP,VEGF,and sFlt-1 were detected by enzyme-linked immunosorbent assay.The prenatal diagnosis value of color Doppler ultrasound,AFP,CK,VEGF,sFlt-1 and combination of 4 indicators before for placental implantation were analyzed.Results Serum AFP,CK and VEGF were significantly higher in the placenta-implanted group than in the non-implanted group and the control group,and the differences were statistically significant(P<0.05),and sFlt-1 was lower than the placenta-implanted group and the control group,and the difference was statistically significant(P<0.05).There was no significant difference in serum AFP,CK,VEGF and sFlt-1 between the placenta-implanted group and the control group(P>0.05).The consistency of color Doppler ultrasound in the diagnosis of placenta was worse than pathological(P>0.05).The sensitivity of color Doppler ultrasound,AFP,CK,VEGF and sFlt-1 in the diagnosis of placenta implantation was 30.56%,80.03%,85.93%,86.72%,84.38%,respectively,and the specificity was 96.30%,87.42%,89.37%,91.05%,and 88.02%.The sensitivity of color Doppler ultrasound combined with AFP,CK,VEGF and sFlt-1 to diagnose placenta implantation was increased to 94.31%,and specificity was 84.07%.Conclusion Serum AFP,CK,VEGF and sFlt-1 combined with color Doppler ultrasound can effectively improve the diagnosis of placental implantation and have clinical significance.

关 键 词：胎盘植入 彩色多普勒超声 血清学标志物 甲胎蛋白 肌酸激酶 血管内皮生长因子 可溶性血管内皮生长因子受体1 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]