MRI影像联合血清sFlt-1、AFP诊断前置胎盘合并胎盘植入价值  

Diagnostic value of magnetic resonance imaging combined with the levels of serum soluble FMS like tyrosine kinase-1 and alpha fetoprotein of pregnant women for their placenta previa with placenta accreta

作　　者：俞晓倩 高霞[1] 欧阳柳 孙雪 YU Xiaoqian;GAO Xia;OUYANG Liu;SUN Xue Shiyan(People's Hospital(Affiliated People's College of Hubei University of Medicine),Hubei Province,442000)

机构地区：[1]湖北省十堰市人民医院(湖北医药学院附属人民院),442000

出　　处：《中国计划生育学杂志》2023年第4期903-906,911,共5页Chinese Journal of Family Planning

摘　　要：目的:分析磁共振成像(MRI)影像联合血清可溶性FMS样酪氨酸激酶-1(sFlt-1)、甲胎蛋白(AFP)检测对前置胎盘合并胎盘植入的诊断价值。方法:收集2021年1月-2022年1月本院收治的疑似前置胎盘合并胎盘植入患者278例临床资料,经病理确诊前置胎盘合并胎盘植入142例为病例组,同期规律产前检查健康孕妇136例为对照组。酶联免疫吸附法检测两组血清sFlt-1、AFP水平;Pearson法分析病例组血清sFlt-1与AFP水平的相关性;以病理结果为金标准,分析MRI影像、血清sFlt-1、AFP对前置胎盘合并胎盘植入的诊断效能。结果:病例组sFlt-1(2.52±0.43 ng/ml)、AFP(62.91±7.19 U/ml)高于对照组(1.12±0.15 ng/ml、30.72±3.57 U/ml),且病例组中粘连型、穿透型、植入型患者血清sFlt-1、AFP表达水平逐渐升高(均P<0.05);病例组血清sFlt-1与AFP水平呈正相关(P<0.05);病例组患者胎盘内信号不均、胎盘内增粗血管影、胎盘与子宫分界不清特征比例高于对照组,膀胱突起、子宫局部外凸特征比例低于对照组(均P<0.05);MRI影像联合血清sFlt-1、AFP检测对前置胎盘合并胎盘植入的灵敏度(84.8%)、准确度(80.2%)均高于单独指标诊断。结论:前置胎盘合并胎盘植入患者血清sFlt-1、AFP异常升高,MRI影像联合血清sFlt-1、AFP检测可提高诊断灵敏度。Objective:To analyze the diagnostic value of the results of magnetic resonance imaging(MRI)combined with the levels of serum soluble FMS like tyrosine kinase-1(sFlt-1)and alpha fetoprotein(AFP)of pregnant women for their placenta previa and placenta accreta.Methods:The clinical data of 278 pregnant women with suspected pla-centa previa and placenta accreta from January 2021 to January 2022 were collected.142 women with confirmed placen-ta previa and placenta accreta based on pathological examination were included in study group,and another 136 health pregnant women were included in control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the serum sFlt-1 and AFP levels.Pearson method was used to analyze the correlation between the serum sFl-1 level of the women in the study group and their AFP level.The pathological results were as the gold standard of dognosing placenta previa and placenta accreta,the diagnostic efficacy of MRI results and the serum sFlt-1 and AFP levels of the women for their placenta previa and placenta accreta was analyzed.Results:The levels of sFlt1(2.52±0.43 ng/m)and AFP(62.91±7.19 U/ml)of the women in the study group were significantly higher than those(1.12±0.15 ng/ml and 30.72±3.57 U/ml)of the women in the control group.The expression levels of serum sFl-1 and AFP of the women.with adhesion,penetration,and implantation of placenta accreta in the study group had increased gradually(all P<0.05).The serum sFlt1 level of the women in the study group was positively correlated with their AFP level(P<0.05).The proportions of uneven signal in placenta,the thickened blood vessel shadow in placenta,the unclear boundary between the placenta and the uterus of the women in the study group were significantly higher than those of the women in the control group,and the proportions of the bladder protrusion and local exudation of the uterus of the women in the study group were significantly lower than those of the women in the control group(all P<0.05).The sensitivity(84.8%)and the ac

关 键 词：前置胎盘合并胎盘植入 磁共振成像 可溶性FMS样酪氨酸激酶-1 甲胎蛋白 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]