阴道彩色多普勒超声联合血清VEGF和PAPP-A及孕酮在异位妊娠中的诊断价值  

Value of vaginal color doppler ultrasound combined with serum VEGF,PAPP-1 and progesterone in diagnosis of ectopic pregnancy

作　　者：曹海秀[1] Cao Haixiu(Department of Ultrasonic,First People's Hospital of Jiujiang,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院超声影像科,江西九江332000

出　　处：《当代医学》2020年第34期16-18,共3页Contemporary Medicine

基　　金：江西省卫生健康委员会科技计划项目(20187110)。

摘　　要：目的探讨阴道彩色多普勒超声联合血清VEGF和PAPP-A及孕酮在异位妊娠中的诊断价值。方法选取2018年5月至2019年4月本院收治的早期未破裂EP患者109例作为EP组,并选取同期宫内早期妊娠女性102例作为宫内早期妊娠组。行阴道彩色多普勒超声检查,测定子宫内膜厚度。酶联免疫吸附法(ELISA)检测血清VEGF和PAPP-A浓度,时间分辨荧光免疫法测定血清孕酮浓度,计算得出VEGF/(PAPP-A×孕酮)。受试者诊断曲线(ROC)的曲线下面积(AUC)、灵敏度、特异性、阳性预测值及阴性预测值用于评价VEGF/(PAPP-A×孕酮)和阴道超声及两者联合对EP的诊断价值。比较两组患者子宫内膜厚度、VEGF、PAPP-A、孕酮及VEGF/(PAPP-A×孕酮);分析各指标诊断学。结果EP患者子宫内厚度显著低于宫内早期妊娠组,而VEGF显著高于宫内早期妊娠组,PAPP-A和孕酮显著低于宫内早期妊娠组。VEGF/(PAPP-A×孕酮)显著高于宫内早期妊娠组。联合阴道彩超和VEGF/(PAPP-A×孕酮)方案ROCAUC、诊断灵敏度、特异度和阴阳性预测值均显著高于单一诊断方案。结论联合阴道彩超和VEGF/(PAPP-A×孕酮)方案或可作为临床诊断EP的可行方法。Objective To explore the value of colcolor doppler ultrasound combined with serum VEGF,PAPP-1 and progesterone in diagnosing ectopic pregnancy.Methods 109 patients with early unruptured EP admitted to our hospital from May 2018 to April 2019 were selected as the EP group,and 102 women with early intrauterine pregnancies were selected as control group.The endometrium thickness was measured by transvaginal color doppler ultrasonography.Enzyme linked immunosorbent assay(ELISA)was used to detect the serum concentration of VEGF and PAPP-A.The serum progesterone concentration was determined by time-resolved fluoro immunoassay,and the VEGF/(PAPP-A×progesterone)was calculated.The diagnostic area(AUC)of the diagnostic curve(ROC),sensitivity,specificity,positive predictive value and negative predictive value were used to evaluate the value of VEGF/(PAPP-A×progesterone)and transvaginal ultrasound and their combination for diagnosing EP.Endometrial thickness,VEGF,PAPP-A,progesterone,and VEGF/(PAPP-A×progesterone)were compared between the two groups.Diagnostics of each index were analyzed.Results The intrauterine thickness of EP patients were significantly lower than those of normal intrauterine pregnancy,while VEGF increased significantly in EP patients.PAPP-A and progesterone were significantly lower in patients with EP than patients with early intrauterine pregnancy.VEGF/(PAPP-A×progesterone)was significantly up-regulated in the EP group.ROCAUC,diagnostic sensitivity,specificity,negative predictive value and positive predictive value of vaginal color doppler ultrasound combined with VEGF/(PAPP-A×progesterone)scheme were all significantly higher than those of a single diagnostic scheme.Conclusion The combination of vaginal color doppler ultrasound and VEGF/(PAPP-A×progesterone)can be used as a feasible method for clinical diagnosis of EP.

关 键 词：阴道彩超 VEGF PAPP-A 孕酮 异位妊娠 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]