超声联合β-hCG对胎膜早破的预测价值研究  

Predictive value of ultrasound combined withβ-hCG in premature rupture of membranes

作　　者：陈昌钊 符俊娟 符叶柳[2] 吴青京 CHEN Changzhao;FU Junjuan;FU Yeliu;WU Qingjing(Department of Ultrasound,Hainan Maternal and Child Health Hospital,Haikou 570206,Hainan,China;Department of Ultrasound,Haikou Hospital Affiliated to Xiangya Medical College,Central South University,Haikou 570208,Hainan,China)

机构地区：[1]海南省妇幼保健院超声科,海口570206 [2]中南大学湘雅医学院附属海口医院超声科,海口570208

出　　处：《中国性科学》2020年第10期117-120,共4页Chinese Journal of Human Sexuality

摘　　要：目的探讨早期超声检测宫颈角(UCA)联合血清β-人绒毛膜促性腺激素(β-hCG)对孕妇胎膜早破的预测价值。方法选取2017年1月至2017年12月在海南省妇幼保健院超声科做超声检查的147例疑似胎盘早剥患者作为研究对象并设为研究组,采用经阴道超声、β-hCG对其进行诊断。另选取同期海南省妇幼保健院超声科接收的100例正常孕妇设为对照组。比较两组孕妇血清β-hCG水平,并应用Kappa检查分析超声联合β-hCG诊断胎膜早破的临床价值。结果147例疑似胎盘早剥患者中经临床诊断共有122例确诊为胎膜早破,胎膜早破发生率为82.99%(122/147)。其中足月胎膜早破(≥37周)与早产胎膜早破(<37周)分别为42.62%(52/122)和57.38%(70/122)。UCA>90°预测分娩<37周发生胎膜早破灵敏度为82.2%,特异度为52.6%,UCA>90°预测分娩≥37周发生胎膜早破的灵敏度为72.5%,特异度71.2%。β-hCG≥2.48 ng/mL时预测<37周胎膜早破灵敏度为71.6%,特异度为74.7%;β-hCG≥2.48 ng/mL时预测≥37周胎膜早破灵敏度为72.5%,特异度70.9%,超声联合血清β-hCG诊断胎膜早破灵敏度及特异性度别为91.2%和92.5%。结论超声联合血清β-hCG检测孕妇胎膜早破具有一定的预测价值,可为临床胎膜早破诊断提供指导。Objective To investigate the predictive value of early ultrasound detection of cervical angle(UCA)combined with serumβ-human chorionic gonadotropin(β-hCG)for premature rupture of membranes in pregnant women.Methods 147 patients with suspected placental abruption who underwent ultrasound examination in Hainan Maternal and Child Health Hospital from January 2017 to December 2017 were enrolled in the study group.Transvaginal ultrasonography andβ-hCG were used for suspected placental abruption.100 normal pregnant women admitted in the same period were selected as the control group.The serumβ-hCG levels were compared between the two groups,and Kappa was used to analyze the clinical diagnosis value of premature rupture of membranes by ultrasound combined withβ-hCG.Results Among the 147 patients with suspected placental abruption,122 were diagnosed as premature rupture of membranes and the rate of premature rupture of membranes being 82.99%(122/147).The rates of term premature rupture of membranes(≥37 weeks)and premature rupture of membranes(<37 weeks)were 42.62%(52/122)and 57.38%(70/122)respectively.The sensitivity and specificity of UCA>90°for the prediction of premature rupture of membranes in women with gestational age<37 weeks were 82.2%and 52.6%respectively,and those for women with gestational age≥37 weeks were 72.5%and 71.2%.Whenβ-hCG≥2.48 ng/ml,the sensitivity and specificity for the prediction of premature rupture of membranes in women with gestational age<37 weeks were 71.6%and 74.7%respectively,and those for women with gestational age≥37 weeks were 72.5%and 70.9%.The sensitivity and specificity of ultrasound combined with serumβ-hCG in the diagnosis of premature rupture of membranes were 91.2%and 92.5%.Conclusions Transvaginal ultrasound combined with serumβ-hCG detection of premature rupture of membranes in pregnant women has a certain predictive value,which can provide guidance for the diagnosis of premature rupture of membranes.

关 键 词：经阴道超声检查 胎膜早破 妊娠结局 宫颈角 Β-人绒毛膜促性腺激素 

分 类 号：R714[医药卫生—妇产科学]