超声检查联合血清妊娠相关蛋白A诊断早期胎盘早剥价值  

Value of serum pregnancy-associated plasma protein A combined with ultrasonography examination for diagnosing of placental abruption early

作　　者：刘超[1] 方亚平[1] 李斌[1] 李志杰[1] 穆立凤 LIU Chao;FANG Yaping;LI Bin;LI Zhijie;MU Lifeng(Aerospace General Hospital,Beijing,100000)

机构地区：[1]北京航天总医院,100076

出　　处：《中国计划生育学杂志》2022年第11期2629-2633,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨血清妊娠相关蛋白A(PAPP-A)联合超声检查对早期胎盘早剥诊断价值。方法:选取2018年1月-2021年1月于本院筛查随访的高危孕产妇157例临床资料,明确确诊为无胎盘早剥(非胎盘早剥组)112例,胎盘早剥(胎盘早剥组)45例。酶联免疫吸附法检测157例孕产妇血清PAPP-A水平,彩色多普勒超声检查胎盘情况;受试者工作特征曲线(ROC)曲线分析PAPP-A、超声检查诊断胎盘早剥价值,临床结果的一致性采用Kappa检验。结果:胎盘早剥组血清PAPP-A表达水平低于非胎盘早剥组(P<0.05)。诊断胎盘早剥,PAPP-A曲线下面积为0.899,特异性95.5%,敏感度为73.3%,截断值为3.88 U/L。超声检查联合血清PAPPA诊断胎盘早剥敏感度(93.3%)和特异度(93.6%)提高,阴性预测值(97.2%)单独检测(均P<0.05);超声及血清检测结果与临床结果一致性分别为较高、极高(Kappa=0.758、0.848,均P<0.05)。胎盘早剥组发生死胎、子宫胎盘卒中、产后出血、低体质量儿比例高于非胎盘早剥组(P<0.05)。结论:超声检查联合血清PAPP-A检测可提高胎盘早剥临床检出效能。Objective:To investigate the value of serum pregnancy-associated plasma protein A(PAPP-A)combined with ultrasonography examination of pregnant women for diagnosing placental abruption early.Methods:The clinical data of 157 pregnant women with high risk factors from January 2018 to January 2021 were selected in this study,which included 112 cases without placental abruption in group A and 45 cases were with placental abruption in group B.The expression level of serum PAPP-A of the women in the two groups was detected by enzyme-linked immunosorbent assay,and the placenta situation of the women in the two groups was examined by color Doppler ultrasonography.Receiver operator characteristic(ROC)curve was used to analyze the values of PAPP-A level and ultrasonography examination of pregnant women for diagnosing their placental abruption.The consistency of clinical results was determined by Kappa test.Results:The expression level of serum PAPP-A of the women in group B was significantly lower than that of the women in group A(P<0.05).The area under curve,the specificity,the sensitivity,and the cut-off value of the serum PAPP-A level of the women for diagnosing their placental abruption were 0.899,95.5%,73.3%,and 3.88 U/L,respectively.The sensitivity,the specificity,and the negative predictive value of the serum PAPP-A level combined with ultrasonography examination for diagnosing their placental abruption were 93.3%,93.6%,and 97.2%,respectively,which were significantly higher than those of the serum PAPP-A level or ultrasonography examination alone(all P<0.05).The consistency between the ultrasonography examination and serum PAPP-A level of the women for diagnosing their placental abruption and their clinical results were higher and extremely high(Kappa=0.758,0.848,all P<0.05).The proportion of stillbirth,uterine placental apoplexy,and postpartum hemorrhage of the women,and low body weight infants in group B were significantly higher than those in group A(P<0.05).Conclusion:Ultrasound examination combined with the leve

关 键 词：胎盘早剥 早期诊断:妊娠相关蛋白A 超声检查 一致性 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.56[医药卫生—诊断学]