孕中晚期血清AFP、CK联合MRI影像学评估前置胎盘合并胎盘植入价值  

Value of serum alpha fetoprotein and creatine kinase levels combined with magnetic resonance imaging during the second and the third trimester of pregnancy for evaluating the placenta previa complicated with placenta accrete

作　　者：尧美茜 毛锦江[1] 甘冰[1] YAO Meiqian;MAO Jinjiang;GAN Bing(Guigang People's Hospital,Guigang,Guangxi Zhuang Autonomous Region,527100)

机构地区：[1]广西壮族自治区贵港市人民医院,537100

出　　处：《中国计划生育学杂志》2022年第5期1085-1088,1093,共5页Chinese Journal of Family Planning

基　　金：贵港市自筹经费科研项目(贵科项2000038)。

摘　　要：目的:探讨孕中期和孕晚期孕妇血清甲胎蛋白(AFP)、肌酸激酶(CK)联合核磁共振(MRI)影像学对前置胎盘合并胎盘植入的评估价值.方法:回顾性收集本院2018年1月—2021年1月剖宫产分娩的前置胎盘合并胎盘植入患者80例为病例组,其中粘连型29例、植入型27例、穿透型24例,规律产前检查且需MRI检查的剖宫产分娩孕妇60例为对照组.分析各组孕妇孕中、晚期血清AFP、CK水平及MRI检查结果.结果:孕中、晚期病例组穿透型、植入型、粘连型孕妇血清AFP、CK水平依次降低但均高于对照组(P<0.05).MRI对粘连型、植入型、穿透型诊断符合率(92.6%、85.2%、83.3%)无差异(P>0.05).孕中、晚期血清AFP、CK联合MRI评估前置胎盘合并胎盘植入的曲线下面积(AUC)分别为0.924(95%CI:0.805~0.982)和0.905(95%CI:0.821~0.964),灵敏度分别为90.2%、88.4%,特异度分别为95.3%、91.8%.MRI的AUC为0.811(95%CI:0.691~0.863),灵敏度80.7%,特异度93.2%;孕中、晚期血清AFP的AUC分别为0.705(95%CI:0.602~0.764)和0.782(95%CI:0.701~0.835),灵敏度为70.0%、78.4%,特异度为69.3%、71.3%;孕中、晚期血清CK的AUC分别为0.692(95%CI:0.591~0.702)和0.764(95%CI:0.624~0.820),灵敏度为69.9%、75.2%,特异度为74.3%、70.3%.结论:孕中、晚期血清AFP、CK联合MRI影像学检查对早期评估前置胎盘合并胎盘植入具有较高临床价值.Objective: To investigate the value of serum alpha fetoprotein(AFP)and creatine kinase(CK)levels combined with magnetic resonance imaging(MRI) during the second and the third trimester of pregnancy for evaluating the placenta previa complicated with placenta accrete of pregnant women. Methods: A total of 80 pregnant women with placenta previa complicated with placenta accreta who had delivered by cesarean section from January 2018 to January 2021 were selected in research group retrospectively, which included 29 cases with adhesion type of placenta previa in group A,27 cases with implant type of placenta previa in group B, and 24 cases with penetration type of placenta previa in group C according to the results of MRI. In addition, 60 pregnant women who required regular antenatal examination and MRI examination after cesarean section and during the same period were selected in control group. The serum AFP,CK levels and the results of MRI examination during the second and the third trimester of pregnancy of the women in the two groups were analyzed. Results: The serum AFP and CK levels of the women in group C, group B, and group A had decreased gradually, and which of the women were all significantly higher than those of the women in the control group(P<0.05). There was no significant difference in the diagnostic coincidence rate of MRI(92.6%, 85.2% vs. 83.3%) of the women among group A, group B, and group C(P>0.05). The area under the curve(AUC) of serum AFP and CK levels combined with MRI for evaluating the placenta previa complicated with placenta implantation during the second trimester of pregnancy were 0.924(95%CI:0.805-0.982)and 0.905(95%CI:0.821-0.964),respectively,the sensitivity of which were 90.2% and 88.4%,respectively,and the specificity of which were95.3% and 91.8%,respectively.The AUC of MRI for evaluating the placenta previa complicated with placenta implantation during the third trimester of pregnancy was 0.811(95%CI:0.691-0.863),the sensitivity of which was 80.7%,and the specificity of which was

关 键 词：前置胎盘 胎盘植入 甲胎蛋白 肌酸激酶 核磁共振 评估价值 

分 类 号：R714.2[医药卫生—妇产科学]