超声logistic回归评分模型及血清VEGF、sFlt-1诊断前置胎盘附着、侵袭子宫肌层程度价值  

Value of Logistic regression scoring model of ultrasound examination and the levels of serum vascular endothelial growth factor and sFlt-1 of pregnant women with placenta previa for diagnosing of placenta adhesion and placenta invasion degree of myometrium

作　　者：黄巧爱 洪敏[1] Huang Qiaoai;Hong Min(Pan'an People's Hospital,Zhejiang Province,322300)

机构地区：[1]浙江省磐安县人民医院,322300

出　　处：《中国计划生育学杂志》2022年第4期887-890,894,共5页Chinese Journal of Family Planning

摘　　要：目的:评估产前超声logistic回归评分模型、血清血管内皮生长因子(VEGF)、血管内皮生长因子受体1(sFlt-1)水平诊断前置胎盘患者胎盘附着、侵袭子宫肌层程度价值。方法:回顾性收集2018年6月-2020年6月本院住院分娩的确诊前置胎盘患者215例,均行子宫彩色多普勒超声及血清VEGF、sFlt-1检测并具有完整临床检查记录。按照术后病理结果胎盘侵袭子宫肌层程度分为胎盘无附着或异常附着(非侵入+PA组)172例和胎盘异常侵袭组(PI+PP组)43例,运用logistic回归分析构建回归评分模型;根据胎盘侵袭子宫肌层程度分为胎盘非侵入、胎盘粘连(PA)、肌层植入(PI)和穿透性植入(PP)等4个组,比较组间血清VEGF、sFlt-1水平差异。运用受试者工作曲线(ROC)分析评估产前超声评分模型、血清VEGF和sFlt-1水平对前置胎盘患者胎盘附着、侵袭子宫肌层程度的诊断价值。结果:产前超声logistic回归评分模型为lnP/1-P=2.817+1.768X_(1)+3.625X_(2)-0.559X_(3)-1.823X_(4)+3.072X_(5)-2.785X_(6)。血清VEGF水平PI组与PP组无差异,其它各组间有差异;血清sFlt-1水平非植入组与PA组无差异,其它各组间有差异(均P<0.05)。ROC曲线分析,超声及血清VEGF、sFlt-1诊断前置胎盘附着、侵袭子宫肌层程度的曲线下面积分别为0.801、0.717和0.706,诊断临界值分别为5.245、279.80pg/ml和2.66pg/ml。结论:产前超声评分模型、血清VEGF和sFlt-1对前置胎盘附着、侵袭子宫肌层程度有一定诊断价值。Objective:To evaluate the value of Logistic regression scoring model of antenatal ultrasound examination and the levels of serum vascular endothelial growth factor(VEGF)and sFlt-1of pregnant women with placenta previa for diagnosing their placenta adhesion and their placenta invasion degree of myometrium.Methods:A total of 215pregnant women with placenta previa who all had accepted color Doppler ultrasound examionation and serum VEGF and sFlt-1detection,and had the complete clinical examination records from June 2018to June 2020were collected retrospectively.These women were divided into group A(172women without placental attachment or abnormal attachment)and group B(43women with placental abnormal invasion)according to the postoperative pathological results.Logistic regression analysis was used to construct the regression score model.According to the degree of the placenta invasion,these women were also divided into non-invasive placenta group,PA group,PI group,and PP group.The differences of serum VEGF and sFlt-1levels of the women were compared among these groups.Receiver operator characteristic curve(ROC)was used to analyze and evaluate the value of the levels of serum VEGF and sFlt-1of the pregnant women with placenta previa for diagnosing their placenta adhesion and placenta invasion degree of myometrium.Results:Logistic regression score model of antenatal ultrasound examination was lnP/1-P=2.817+1.768X1+3.625 X2-0.559X3-1.823X4+3.072X5-2.785X6.There was no significant difference in the serum VEGF level of the women between group PP and group PI,but there was significant difference in the serum VEGF level of the women among other groups.There was no significant difference in the serum SFLT-1level of the women between the non-invasive placenta group and group PA,but there was significant difference in the serum SFLT-1level of the women among other groups(all P<0.05).The areas under of ROC of the ultrasound examination,serum VEGF level,and serum sFLT-1level for diagnosing placenta previa adhesion and invasion

关 键 词：前置胎盘 胎盘附着 超声评分模型 血管内皮生长因子 可溶性血管内皮生长因子受体1 诊断 

分 类 号：R714.2[医药卫生—妇产科学]