阴式超声测量双侧搏动指数结合血清雌孕激素水平检测在异位妊娠患者诊断中的作用  

Efficacy of vaginal ultrasound measurement of bilateral pulsatility index in combination with serum estrogen and progesterone testing in the diagnosis of ectopic pregnancy

作　　者：陈雨骤 周俊宇 CHEN Yuzhou;ZHOU Junyu(Department of Ultrasound,Chongming Branch of Xinhua Hospital,Shanghai 202150,China)

机构地区：[1]新华医院崇明分院超声科,上海202150

出　　处：《分子影像学杂志》2022年第3期358-362,共5页Journal of Molecular Imaging

摘　　要：目的 研究阴式超声测量双侧搏动指数(PI)结合血清雌孕激素水平检测在异位妊娠患者诊断中的效能。方法 选取2019年2月~2021年2月在本院诊断并治疗的107例异位妊娠患者为观察组,另选取同期在本院同期产检的宫内早孕组患者107例作为对照组,比较两组患者的阻力指数(RI)、功能侧PI、非功能侧PI、峰值流速、舒张末期流速、卵泡雌激素、黄体生成素、孕酮激素以及雌二醇(E2)水平。分析功能侧PI、非功能侧的PI、E2及孕酮激素联合检测对异位妊娠的诊断效能。结果 观察组患者的RI低于对照组(t=51.534,P<0.001),功能侧PI(t=5.884,P<0.001)、非功能侧PI(t=8.565,P<0.001)、峰值流速(t=45.597,P<0.001)、舒张末期流速(t=12.302,P<0.001)水平高于对照组;观察组患者的卵泡雌激素(t=3.676,P<0.001)、黄体生成素(t=6.334,P<0.001)、E2(t=28.259,P<0.001)、孕酮激素(t=48.787,P<0.001)水平低于对照组。功能侧PI、非功能侧的PI、孕酮激素联合E2检测在诊断异位妊娠中的特异度明显较单独检测高。通过ROC曲线分析,功能侧PI、非功能侧PI、E2及孕酮激素联合检测对异位妊娠的诊断的曲线下面积高于单独检测,功能侧PI、非功能侧的PI、E2及孕酮激素临界值依次为2.58、2.76、422.56 pmol/L、15.13 ng/m L。结论 阴式超声测量双侧PI结合血清雌孕激素水平对于异位妊娠患者诊断具有显著的意义。Objective To evaluate the efficacy of vaginal ultrasound measurement of bilateral pulsatility index(PI) in combination with serum estrogen and progesterone testing in the diagnosis of ectopic pregnancy. Methods A total of 107 women with ectopic pregnancy diagnosed and treated in Chongming Branch of Xinhua Hospital from February 2019 to February 2021 were selected as observation group, and another 107 women in early intrauterine pregnancy who underwent prenatal examination in our hospital during the same period were selected as control group. Parameters including resistance index(RI), bilateral PI, peak systolic velocity, end-diastolic velocity, follicle-stimulating hormone, luteinizing hormone,estradiol(E2) and progesterone were detected in both groups. Then the diagnostic efficacy of combined detection of PI, E2 and progesterone for ectopic pregnancy were evaluated. Results Compared with control group, observation group had a decrease in RI(t=51.534, P<0.001), along with an increase in functional PI(t=5.884, P<0.001), non functional PI(t=8.565, P<0.001), peak systolic velocity(t=45.597, P<0.001) and end-diastolic velocity(t=12.302, P<0.001). Observation group had significantly lower levels of follicle-stimulating hormone(t=3.676, P<0.001), luteinizing hormone(t=6.334, P<0.001), E2(t=28.259, P<0.001) and progesterone(t=48.787, P<0.001) compared with control group. The combined detection of bilateral PI, progesterone and E2 achieved higher diagnostic efficacy than the separate detection. ROC curve indicated that the area under the curve of combined detection of bilateral PI, progesterone and E2 in the diagnosis of ectopic pregnancy was larger than that of separate detection, and the cut-off values of functional PI, non functional PI, E2 and progesterone were 2.58, 2.76, 422.56 pmol/L and15.13 ng/m L, respectively. Conclusion Application of vaginal ultrasound measurement of bilateral PI in combination with serum estrogen and testing is of great significance in the clinical diagnosis of ectopic pregnancy.

关 键 词：阴式超声 搏动指数 异位妊娠 雌二醇 孕酮激素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]