超声结合血清肌酸激酶、同工酶检测对胎盘植入的诊断价值  

Value of ultrasound combined with the levels of serum creatine kinase and isoenzyme for diagnosing placental implantation of pregnant women

作　　者：范田依 庞静 王艳蕾 王守业 赵立武 FAN Tianyi;PANF Jing;WANG Yanlei;WANG Shouye;ZHAO Liwu(Qinhuangdao Military Hospital, Hebei Province, 066000;Qinhuangdao Maternal and Child Health Care Hospital;Ninghe District Hospital of Tianjin)

机构地区：[1]河北省秦皇岛军工医院,066000 [2]河北省秦皇岛市妇幼保健院 [3]天津市宁河区医院

出　　处：《中国计划生育学杂志》2020年第12期2059-2062,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨超声联合血清肌酸激酶(CK)、肌酸激酶同工酶杂化型(CK-MB)及肌酸激酶同工酶肌肉型(CK-MM)检测对胎盘植入的诊断价值。方法:回顾性收集2017年8月—2019年8月在本院产科产前检查并住院分娩、存在胎盘植入高危因素的95例孕妇临床资料,根据术中诊断及术后胎盘病理检查结果分为非胎盘植入组(n=62)和胎盘植入组(n=33)。采用彩色多普勒超声诊断仪,于产前腹部超声检查胎盘;使用酶联免疫吸附法检测血清CK、CK-MB、CK-MM水平并绘制受试者工作特征曲线(ROC),分析对胎盘植入的诊断价值。结果:胎盘植入组超声诊断符合率(91.9%)与非胎盘植入组(84.9%)比较无差异(P>0.05),血清CK(117.96±34.08 U/L)、CK-MB(9.04±2.55 U/L)、CK-MM(98.75±26.49 U/L)均高于非胎盘植入组(P<0.05)。血清CK、CK-MB、CK-MM水平诊断胎盘植入的ROC曲线下面积分别为0.916、0.821、0.869,最佳截断值分别为92.35 U/L、6.41 U/L、76.09 U/L,超声联合血清CK、CK-MB、CK-MM检测的准确度(91.6%)、灵敏度(93.9%)、特异度(90.3%)均高于单独检测。结论:超声联合血清CK、CK-MB、CK-MM检测可提高产前胎盘植入诊断的准确度和灵敏度。Objective:To investigate the value of ultrasound combined with the levels of serum creatine kinase(CK),creatine kinase isoenzyme(CK-MB),and creatine kinase isoenzyme muscle type(CK-MM)for diagnosing placental implantation of pregnant women.Methods:From August 2017 to August 2019,95 pregnant women with high risk factors of placental implantation were selected in study objects.And according to the results of intraoperative diagnosis and postoperative placental pathology,they were divided into 62 women without placental implantation group in group A and 33 women with placental implantation in group B.Before delivery,the placenta of these pregnant women was examined by abdominal ultrasonography with Voluson 730 expert color Doppler ultrasound,and the levels of serum CK,CK-MB and CK-MM of these women were detected by enzyme-linked immunosorbent assay(ELISA).And the receiver operating characteristic(ROC)curve was used to analyze the value of serum CK,CK-MB and CK-MM levels for diagnosing placental implantation.Results:The coincidence rate of ultrasound diagnosis of women in group B was 91.9%,which had no significant different from that(84.9%)of women in group A(P>0.05).The levels of serum CK(117.96±34.08 U/L),CK-MB(9.04±2.55 U/L),and CK-MM(98.75±26.49 U/L)of women in group B were all significant higher than those of women in group A(P<0.05).The area under of ROC curve of the serum CK,CK-MB,and CK-MM levels for diagnosing the placental implantation was 0.916,0.821,and 0.869,respectively,and which’s optimal cutoff values were 92.35 U/L,6.41 U/L,and 76.09 U/L,respectively.The accuracy(91.6%),the sensitivity(93.9%),and the specificity(90.3%)of ultrasound combined with serum CK,CK-MB,and CK-MM levels for diagnosing the placental implantation were all significant higher than those of ultrasound,the serum CK level,CK-MB level,or CK-MM level alone.Conclusion:Ultrasound combined with serum CK,CK-MB and CK-MM levels can improve the accuracy and sensitivity of prenatal placental implantation diagnosis.

关 键 词：胎盘植入 超声 血清学 肌酸激酶 肌酸激酶同工酶杂化型 肌酸激酶同工酶肌肉型 诊断价值 

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]