三维超声联合妊娠相关血浆蛋白A诊断胎盘植入价值  

Value of three-dimensional ultrasonography combined with pregnancy associated plasma protein A for diagnosing placental implantation

作　　者：周冰峰[1] 阚长利[1] 侯敬[1] 梁爽 ZHOU Bingfeng;KAN Changli;HOU Jing;LIANG Shuang(Affiliated Hospital of Chengde Medical College,Hebei Province,067000)

机构地区：[1]承德医学院附属医院,067000

出　　处：《中国计划生育学杂志》2021年第6期1233-1236,共4页Chinese Journal of Family Planning

基　　金：承德市科学技术研究与发展计划项目(201804A018)。

摘　　要：目的:探究三维超声联合妊娠相关血浆蛋白A(PAPP-A)诊断胎盘植入价值。方法:选取2015年12月-2018年12月于本院剖宫产分娩孕妇400例,根据分娩后病理结果分为胎盘植入组254例和非胎盘植入组146例。所有孕妇均行产前三维超声检查及血清中PAPP-A、血管内皮生长因子(VEGF)水平测定,以分娩后病理结果为“金标准”,比较三维超声、血清PAPP-A水平及两者联合对胎盘植入的诊断价值。结果:胎盘植入组血清PAPP-A水平(685.69±201.47g/L)低于非胎盘植入组(896.37±245.26g/L),VEGF水平(342.62±37.84 pg/ml)高于非胎盘植入组(278.41±34.19 pg/ml)(P<0.05);三维超声、血清PAPP-A水平及两者联合检测诊断胎盘植入的灵敏度分别为82.7%、 81.9%、89.4%;特异度分别为84.3%、81.5%、89.0%,诊断准确度分别为83.3%、81.8%、89.3%。结论:三维超声联合血清PAPP-A检测能显著提高胎盘植入的诊断灵敏度和准确性,具有较好的临床诊断价值。Objective: To explore the value of three-dimensional ultrasound combined with pregnancy associated plasma protein A(PAPP-A) level for diagnosing placental implantation. Methods: From December 2015 to December 2018, 400 pregnant women who underwent cesarean section were selected as the study objects. According to the analysis of pathological results after delivery, they were divided into 254 women with placenta implantation in group A and 146 women without placenta implantation in group B. All these women were examined by prenatal three-dimensional(3D) ultrasonography, and the levels of serum PAPP-A and vascular endothelial growth factor(VEGF) of these women were measured before delivery. Based on the pathological results after delivery as the "gold standard", the diagnostic value of 3D ultrasonography, the serum PAPP-A level, or the combination of 3D ultrasonography and serum PAPP-A level for placenta implantation was compared. Results: The serum PAPP-A level(685.69±201.47 g/L) of the women in group A was significant lower than that(896.37±245.26 g/L) of the women in group B, but the serum VEGF level(342.62±37.84 pg/ml) of the women in group A was significant higher than that(278.41±34.19 pg/ml) of the women in group B(P<0.05). The sensitivity of 3D ultrasonography, serum PAPP-A level, and the combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation were 82.7%, 88.9%, and 89.4%, respectively. The specificity of 3D ultrasonography, serum PAPP-A level, and the combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation were 84.3%, 81.5%, and 89.0%, respectively. The diagnostic accuracy of 3D ultrasonography, serum PAPP-A level, and the combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation were 83.3%, 81.8%, and 89.3%, respectively. Conclusion: The combination of 3D ultrasonography and serum PAPP-A level for diagnosing placental implantation can significantly improve the sensitivity and the accuracy,

关 键 词：胎盘植入 三维超声 妊娠相关血浆蛋白A 诊断价值 

分 类 号：R714.462[医药卫生—妇产科学]