阴道彩超联合血清β-HCG、CK、VEGF诊断早期异位妊娠  

The value of the uterine hemogram imaging by transvaginal color ultrasound combined with serumβ-hCG,CK and VEGF for diagnosing of early ectopic pregnancy

作　　者：孙艳芳 彭月享 蔡炜琼 周长华 谢丽 周丽丽 SUN Yanfang;PENG Yuexiang;CAI Weiqiong;ZHOU Changhua;XIE Li;ZHOU Lili(The Third Hospital of Wuhan, Hubei Province, 430000)

机构地区：[1]湖北省武汉市第三医院,430000

出　　处：《中国计划生育学杂志》2020年第12期2077-2080,2138,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨阴道彩超血流图像联合血清β-人绒毛膜促性腺激素(β-HCG)、肌酸激酶(CK)、血管内生长因子(VEGF)诊断异位妊娠的价值。方法:选择2017年2月—2019年10月本院诊治的异位妊娠孕妇80例(异位妊娠组)和经B超声像图诊断确认宫内正常妊娠孕妇50例(宫内妊娠组),均经阴道彩超检查并检测血清β-HCG、CK、VEGF水平,分析各指标诊断异位妊娠价值。结果:异位妊娠组螺旋动脉显示率(6.3%)小于宫内妊娠组,子宫动脉血流阻力指数(RI)(0.68±0.21)大于宫内妊娠组,搏动指数(PI)(1.85±0.25)、血清β-HCG(1023.52±126.35 U/L)、CK(70.25±6.59 U/L)低于宫内妊娠组,VEGF(206.31±65.24 pg/ml)水平高于宫内妊娠组(P<0.05)。ROC曲线分析,子宫动脉RI、子宫动脉PI、β-HCG、CK、VEGF诊断异位妊娠的曲线下面积(AUC)分别为0.883、0.528、0.806、0.759、0.506。超声联合血清学指标诊断的AUC为0.943,敏感性(93.8%)、特异性(88.0%)高于单独检测。结论:经阴道彩超获得的参数子宫动脉RI、血清β-HCG和VEGF对异位妊娠具有诊断价值,联合阴道彩超和血清学指标可提高异位妊娠的诊断效能。Objective:To explore the value of the uterine hemogram imaging by transvaginal color ultrasound combined with the levels of serumβ-hCG,creatine kinase(CK),and VEGF of women for diagnosing their early ectopic pregnancy.Methods:From February 2017 to October 2019,80 pregnant women with ectopic pregnancy were selected in study group and 50 normal pregnant women confirmed by B-ultrasonic were selected in control group.The women in the two groups were examinated by transvaginal color ultrasound,and their serumβ-hCG,CK and VEGF levels were detected.The value of the results of transvaginal color ultrasound examination combined with the levels of serumβ-hCG,CK and VEGF of women for diagnosing their early ectopic pregnancy was analyzed.Results:The spiral artery display rate(6.3%)of women in the study group was significant lower than that of women in the control group.The values of the resistance index(RI)and the pulse index(PI)of uterus arterial blood flow,serum-HCG level,and CK level of women in the study group were 0.68±0.21,1.85±0.25,1023.52±126.35 U/L,and 70.25±6.59 U/L,which were significant lower than those of women in the control group,but the VEGF level of women in the study group(206.31±65.24 pg/ml)was significant higher than that of women in the control group(P<0.05).ROC curve analysis showed that the AUC of the of RI values and PI value of uterine artery,β-HCG level,CK level,and VEGF level for diagnosing ectopic pregnancy were 0.883,0.528,0.806,0.759,and 0.506,respectively.The AUC(0.943),the sensitivity(93.8%),and the specificity(88.0%)of ultrasound combined with the levels ofβ-HCG,CK and VEGF for diagnosing ectopic pregnancy were significant higher than those of ultrasound,β-HCG level,CK level,or VEGF level alone.Conclusion:The RI of uterus by transvaginal ultrasound,and the levels of serumβ-hCG and VEGF have some value for diagnosing ectopic pregnancy,and the combination of vaginal ultrasound and serological indicators levels can improve the diagnostic efficiency.

关 键 词：异位妊娠 阴道彩色超声 血清学检测 Β-人绒毛膜促性腺激素 肌酸激酶 血管内生长因子 诊断效能 

分 类 号：R714.22[医药卫生—妇产科学]