超声检测子宫内膜容受性在单角子宫妊娠结局评估中的价值  

Value of Endometrial Receptivity by Ultrasound in the Evaluation of Pregnancy Outcome in Unicornuate Uterus

作　　者：刘昕[1] 杨梅 LIU Xin;YANG Mei(Department of Ultrasound Medicine,Huangshi Maternal and Child Health Hospital,Huangshi,Hubei 435000,China)

机构地区：[1]黄石市妇幼保健院超声医学科,湖北黄石435000

出　　处：《转化医学杂志》2023年第2期92-95,共4页Translational Medicine Journal

基　　金：湖北省卫生健康委员会科研项目(WJ2021M043)。

摘　　要：目的探讨超声检测子宫内膜容受性在单角子宫妊娠结局评估中的价值。方法回顾性分析2011年1月—2021年5月收治的单角子宫妊娠46例临床资料,患者均行阴道超声检查,比较不同子宫内膜容受性分型患者超声参数。以子宫内膜容受性A、B型作为妊娠成功的预测指标,C型作为妊娠失败的预测指标,以实际妊娠结局作为金标准,计算超声检测子宫内膜容受性预测妊娠结局的敏感度、特异度、阳性预测值、阴性预测值、准确度和Kappa值。结果46例中子宫内膜容受性A型17例(36.96%),B型22例(47.83%),C型7例(15.22%)。不同子宫内膜容受性分型患者子宫内膜厚度、收缩期血流峰值/舒张末期血流速度、搏动指数、阻力指数比较差异均无统计学意义(P>0.05)。子宫内膜容受性分型A型患者妊娠成功率明显高于C型(P<0.05),但A型与B型、B型与C型患者妊娠成功率比较差异均无统计学意义(P>0.05)。超声检测子宫内膜容受性对单角子宫妊娠结局的预测敏感度、特异度、阳性预测值、阴性预测值、准确度和Kappa值分别为96.55%、35.29%、71.79%、85.71%、73.91%、0.36。结论超声检测子宫内膜容受性预测单角子宫妊娠结局的价值较高,并可为单角子宫妊娠患者的诊治提供重要的指导作用。Objective To explore the value of endometrial receptivity by ultrasound in the evaluation of pregnancy outcome in unicornuate uterus.Methods The clinical data of 46 patients with unicornuate uterus pregnancy admitted from January 2011 to May 2021 were retrospectively analyzed.All patients underwent vaginal ultrasound examination,and the ultrasound parameters of patients with different endometrial receptivity types were compared.Using endometrial receptivity types A and B as predictors of pregnancy success,type C as predictors of pregnancy failure,and the actual pregnancy outcome as the gold standard,the predictive sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and Kappa value of endometrial receptivity by ultrasound for pregnancy outcome were calculated.Results Of the 46 cases,17 cases(36.96%)had endometrial receptivity type A,22 cases(47.83%)had endometrial receptivity type B,and 7 cases(15.22%)had endometrial receptivity type C.There were no significant differences in endometrial thickness,peak systolic/diastolic blood flow velocity,pulsation index,and resistance index among patients with different endometrial receptivity types(P>0.05).The pregnancy success rate of patients with endometrial receptivity type A was significantly higher than that of patients with type C,but no significant difference was found between patients with type A and those with type B,and between patients with type B and those with type C(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and Kappa values of endometrial receptivity by ultrasound in predicting the pregnancy outcome in unicornuate uterus were 96.55%,35.29%,71.79%,85.71%,73.91%,and 0.36,respectively.Conclusion Endometrial receptivity by ultrasound has a high value in predicting the pregnancy outcome of unicornuate uterus,which can provide important guidance for the diagnosis and treatment of patients with unicornuate uterus pregnancy.

关 键 词：单角子宫 子宫内膜容受性 超声检查 子宫内膜厚度 搏动指数 阻力指数 妊娠结局 预测价值 

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]