血清检测联合阴道超声评估早期先兆流产的诊断价值分析  

Serum detection of pregnant women at 5–7 weeks of pregnancy combined with vaginal ultrasound to evaluate early threatened abortion and its guiding value for prenatal and postnatal care

作　　者：李升华 符玉蕾 邢慧云 LI Shenghua;FU Yulei;XING Huiyun(Sanya Maternal and Child Health Hospital,Sanya,Hainan 572000,China)

机构地区：[1]三亚市妇幼保健院,海南三亚572000

出　　处：《中国优生与遗传杂志》2021年第2期174-178,共5页Chinese Journal of Birth Health & Heredity

基　　金：三亚市妇幼保健院金椰种子基金(JYZZ-201918)。

摘　　要：目的探讨孕5~7周孕妇血清检测联合阴道超声评估早期先兆流产的诊断价值,以指导优生优育。方法选取200例孕5~7周早期先兆流产患者(先兆流产组)与100例早孕正常妊娠者(正常妊娠组)作为研究对象,研究时间为2019年6月-2020年3月,其中先兆流产组按照妊娠结局分为继续妊娠组(n=100)与难免流产组(n=100),均对其进行血清检测,以及阴道超声检查,分析其受试者工作特征曲线(ROC)。结果先兆流产组糖类抗原-125(serum carbohydrate antigen-125,CA125)、阻力指数(resistance index,RI)、收缩期上升支加速度时间(ascending acceleration time,ACT)、卵黄囊直径高于正常妊娠组,而β-绒毛膜促性腺激素(human chorionic gonadotropin,β-hCG)、孕酮(progesterone,P)、雌二醇(estradiol,E2)、VPS、孕囊直径低于正常妊娠组(P_(均)<0.05)。继续妊娠组的CA125、RI、ACT、卵黄囊直径低于难免流产组,而β-h CG、P、E2、收缩期峰值流速(peak systolic velocity,VPS)、孕囊直径高于难免流产组(P_(均)<0.05)。先兆流产组的CA125、RI、ACT、卵黄囊直径、β-h CG、P、E2、VPS、孕囊直径、六项联合曲线下面积AUC值分别为0.963、0.844、0.682、0.789、0.995、0.988、0.987、0.999、0.871和0.995(P<0.05)。难免流产组的CA125、RI、ACT、卵黄囊直径、β-h CG、P、E2、VPS、孕囊直径、六项联合曲线下面积AUC值分为0.922、0.876、0.740、0.882、0.999、0.997、0.999、0.997、0.999和0.999(P<0.05)。结论CA125、β-hCG、P、E2联合阴道超声有利于减少早期先兆流产的漏诊与误诊,能为其妊娠结局的评估提供参考依据。Objective To investigate the evaluation of early threatened abortion by serum detection of pregnant women at 5–7 weeks of pregnancy combined with vaginal ultrasound and the guiding significance of prenatal and postnatal care.Methods Totally 200 cases of early threatened abortion patients(threatened abortion group)and 100 cases of early pregnancy normal pregnancy(normal pregnancy group)were selected as the research objects.The study period is from June 2019 to March 2020,of which threatened abortion According to the pregnancy outcome,the abortion group was divided into the continued pregnancy group(n=100)and the inevitable abortion group(n=100).Both were subjected to serum testing and vaginal ultrasound to analyze the ROC curve.Results The diameters of CA125,RI,ACT and yolk sac in the threatened abortion group were higher than those in the normal pregnancy group,while the diameters ofβ-h CG,P,E2,VPS and gestational sac were lower than those in the normal pregnancy group(all P<0.05).The diameters of CA125,RI,ACT,and yolk sac in the continuing pregnancy group were lower than those in the unavoidable abortion group,while theβ-hCG,P,E2,VPS and gestational sac diameters were higher than those in the unavoidable abortion group(all P<0.05).The AUC values of CA125,RI,ACT,yolk sac diameter,β-hCG,P,E2,VPS,gestational sac diameter,and area under the six combined curve of threatened abortion group were 0.963,0.844,0.682,0.789,0.995,0.988,0.987,0.999,0.871,and 0.995(P<0.05).The AUC values of CA125,RI,ACT,yolk sac diameter,β-h CG,P,E2,VPS,gestational sac diameter,and area under the six combined curve of the inevitable abortion group were divided into 0.922,0.876,0.740,0.882,0.999,0.997),0.999,0.997,0.999,and 0.999(P<0.05).Conclusion CA125,β-hCG,P,E2 combined with vaginal ultrasound can help reduce the missed diagnosis and misdiagnosis of early threatened abortion,and can provide a reference for the evaluation of pregnancy outcome.

关 键 词：血清检测 阴道超声 早期 先兆流产 优生优育 

分 类 号：R714.21[医药卫生—妇产科学]