彩色多普勒超声联合母体血浆游离胎盘mRNA对产前胎盘植入的诊断价值  

Value of color Doppler ultrasound combined with maternal plasma free placental RNA level for diagnosing of placental implantation

作　　者：魏晏平[1] 温影红[1] WEI Yanping;WEN Yinghong(The First People's Hospital of Foshan,Guangdong Province,528000)

机构地区：[1]广东省佛山市第一人民医院,528000

出　　处：《中国计划生育学杂志》2020年第8期1238-1241,F0002,共5页Chinese Journal of Family Planning

基　　金：广东省佛山市卫生和计生局(20180032)。

摘　　要：目的:探讨彩色多普勒超声联合母体血浆游离胎盘人类胎盘催乳素(HPL)、人绒毛膜促性腺激素β亚单位(β-hCG)、组织因子途径抑制物2(TFPI2)mRNA诊断产前胎盘植入价值。方法:选择2017年8月—2019年6月本院产前检查疑似胎盘植入孕妇131例为研究对象,根据分娩后病理诊断结果分为胎盘植入组(45例)和对照组(86例)。均行经腹彩色多普勒超声检查,应用实时定量PCR检测母体血浆游离胎盘HPL mRNA、β-hCG mRNA、TFPI2mRNA表达。以术后病理结果为准,分析各方法检测胎盘植入的价值。结果:彩色多普勒超声检出胎盘植入32例,诊断胎盘植入的灵敏度71.1%,特异度87.2%。胎盘植入组母体血浆游离胎盘HPL mRNA、β-hCG mRNA、TFPI2mRNA表达均高于对照组(P<0.05),ROC分析HPL mRNA、β-hCG mRNA、TFPI2mRNA诊断胎盘植入的AUC分别为0.634、0.582、0.639,超声+HPL mRNA+β-hCG mRNA6+TFPI2mRNA诊断胎盘植入的灵敏度、特异度、阳性预测值、阴性预测值分别为89.7%、93.2%、92.2%、95.6%,高于单独诊断。结论:彩色多普勒超声联合母体血浆游离胎盘mRNA检测,可提高对产前胎盘植入的诊断价值。Objective:To explore the value of color Doppler ultrasound combined with the mRNA of maternal plasma free placenta human placenta prolactin(HPL),β-Human chorionic gonadotropin subunit(β-hCG),tissue factor pathway inhibitor 2(TFPI2)for diagnosing pregnant women with placental implantation.Methods:131 pregnant women who had been suspected placental implantation were selected as the study subjects.According to the pathological diagnosis after delivery,these women were divided into study group(45 women with placenta implantation)and control group(86 women without placenta implantation).All women had been examined by transabdominal color Doppler ultrasound.The expression of HPL mRNA,β-hCG mRNA and TFPI2 mRNA in maternal plasma were detected by real-time quantitative PCR.The value of different methods for diagnosing placental implantation was analyzed based on the last pathological results.Results:32 women with placenta implantation were diagnosed by color Doppler ultrasound.The sensitivity and the specificity of color Doppler ultrasound for diagnosing placenta implantation were 71.1%and 87.2%,respectively.The expression of HPL mRNA,β-hCG mRNA and TFPI2 mRNA of women in the study group were significant higher than those of women in the control group(P<0.05).ROC analysis showed that the AUC of HPL mRNA,β-hCG mRNA and TFPI2 mRNA for diagnosing placenta implantation were 0.634,0.582 and 0.639,respectively.The sensitivity,the specificity,the positive predictive value,and the negative predictive value of ultrasound combined with the HPL mRNA expression,β-hCG mRNA expression,and TFPI2 mRNA expression for diagnosing placental implantation were 89.7%,93.2%,92.2%,and 95.6%,respectively,which were all significant higher than those of ultrasound,the HPL mRNA expression,β-hCG mRNA expression,or TFPI2 mRNA expression single diagnosis only.Conclusion:Color Doppler ultrasound combined with maternal plasma free placenta mRNA level detection can increase the value for diagnosing prenatal placenta implantation.

关 键 词：胎盘植入 彩色多普勒超声 游离胎盘mRNA 人类胎盘催乳素 人绒毛膜促性腺激素Β亚单位 组织因子途径抑制物2 检测价值 

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]