彩色多普勒超声联合检测血清CK HCG水平对胎盘植入的诊断价值  

Diagnostic Value of Color Doppler Ultrasound Combined with Serum Creatine Kinase and HCG in Placental Implantation

作　　者：周冰峰[1] 阚长利[1] 郭艳巍[1] 侯敬[1] ZHOU Bingfeng;KAN Changli;GUO Yanwei(Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院产科,河北承德067000

出　　处：《河北医学》2021年第9期1535-1539,共5页Hebei Medicine

基　　金：河北省承德市科学技术研究与发展计划项目,(编号:201804A018)。

摘　　要：目的:分析三维彩色多普勒超声(CDFI)联合血清肌酸激酶(CK)、人绒毛膜促性腺激素(HCG)检测对产前胎盘植入的诊断价值。方法:选取2015年-2017年度在承德医学院附属医院分娩的存在胎盘植入高危因素且行剖宫产分娩的孕妇195例作为研究对象,根据分娩后胎盘病理学诊断结果,将孕妇分为胎盘植入组(n=86)和非胎盘植入组(n=109)。采用全自动生化分析仪检测血清中CK、HCG水平;采用CDFI影像学分析两组孕妇的胎盘植入情况;以分娩后胎盘病理诊断结果为金标准,分析血清CK、HCG和CDFI单独及联合检测产前胎盘植入的诊断价值。结果:胎盘植入组孕妇血清CK、HCG水平均高于非胎盘植入组(P <0.05);胎盘植入组孕妇CDFI检测结果中,胎盘与子宫肌层界限模糊、胎盘实质腔隙血流信号、胎盘高度血管化、胎盘不规则液体性质暗区和膀胱突起等特征出现比率均明显高于非胎盘植入组(P<0.05);血清CK、HCG、CDFI单独诊断的敏感度分别为46.51%、48.84%、67.44%,特异度分别为82.41%、80.66%、83.07%,CDFI联合CK、HCG诊断的敏感度为94.85%、特异度为87.62%。结论:CDFI联合血清CK、HCG检测可提高对产前胎盘植入诊断的敏感度及准确性,具有成为产前胎盘植入诊断标准的潜力。Objective:To analyze the diagnostic value of three-dimensional color Doppler flow imaging(CDFI)combined with serum creatine kinase(CK)and human chorionic gonadotropin(HCG)in prenatal placental implantation.Methods:195 pregnant women with high risk factors of placental implantation and underwent cesarean section in the Affiliated Hospital of Chengde Medical University from 2015 to 2017 were selected as the study objects.According to the pathological diagnosis results of placenta after delivery,pregnant women were divided into placental implantation group(n=86)and non fetal disc implantation group(n=109).CK and HCG in serum were detected by automatic biochemical analyzer;CDFI was used to analyze the placental implantation of the two groups;the gold standard was the pathological diagnosis of placenta after delivery,and the diagnostic values of serum CK,CHG and CDFI single and combined diagnoses in prenatal placental implantation were analyzed.Results:The levels of serum CK and HCG in placenta group were higher than those in non placenta group(P<0.05).The results of CDFI showed that the rates of characteristic appearance such as fuzzy boundary between placenta and myometrium,placental parenchymal lacunar blood flow signal,placenta highly vascularized,dark area of irregular fluid property in placenta,and bladder protuberance of pregnant women in placenta implantation group were significantly higher than those in non placenta implantation group(P<0.05).The sensitivities of serum CK,CHG and CDFI single diagnoses were 46.51%,48.84%and 67.44%respectively,and the specificities were 82.41%,80.66%and 83.07%respectively.The sensitivity and specificity of CDF1 combined with CK and CHG were 94.85%and 87.62%respectively.Conclusions:Detection of DFI combined with serum CK and HCG can improve the sensitivity and accuracy of prenatal placental implantation diagnosis,which has the potential to become the diagnostic standard of prenatal placental implantation.

关 键 词：彩色多普勒超声 血清肌酸激酶 人绒毛膜促性腺激素 胎盘植入 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.462[医药卫生—诊断学]