阴道彩色多普勒超声在先兆流产早期诊断中的应用及与血清β-HCG、CA125水平的相关性  

Application of transvaginal color Doppler ultrasound in early diagnosis of threatened abortion and its correlation with serum levels of β-chorionic gonadotropin and carbohydrate antigen-125

作　　者：曹丽[1] 相泓冰[1] 任东方[2] 辛淑文 CAO Li;XIANG Hong-bing;REN Dong-fang;XIN Shu-wen(Department of Ultrasound Imaging,Nanyang Central Hospital,Henan 473000,China)

机构地区：[1]南阳市中心医院超声影像科,河南473000 [2]南阳市中心医院检验科 [3]漯河市中心医院生殖医学与遗传中心

出　　处：《中国卫生检验杂志》2023年第9期1095-1098,共4页Chinese Journal of Health Laboratory Technology

基　　金：2019年河南省医学科技攻关计划联合共建项目(L H G J 20191418)。

摘　　要：目的探讨阴道彩色多普勒超声在先兆流产早期诊断中的应用及与血清β-绒毛膜促性腺激素(β-HCG)、糖类抗原-125(CA125)水平的相关性。方法选取2020年1月—2022年6月在本院就诊的先兆流产产妇98例(观察组),同时选取正常产妇100例作为对照组,比较2组血清β-HCG、CA125水平,以及黄体、子宫动脉血流搏动指数(PI)和阻力指数(RI)。结果经阴道彩超诊断先兆流产的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为92.86%、100.00%、96.46%、100.00%和93.46%;观察组黄体血流PI、RI高于对照组(P<0.05);观察组血清β-HCG低于对照组(P<0.05),而CA125高于对照组(P<0.05);黄体血流参数PI、RI与β-HCG成负相关(r值分别为-0.401、-0.465,P<0.05),而与CA125成正相关(r值分别为0.511、0.492,P<0.05);观察组保胎失败产妇黄体血流PI、RI和CA125高于保胎成功产妇(P<0.05),而β-HCG低于保胎成功产妇(P<0.05);黄体血流PI、RI联合血清β-HCG、CA125预测先兆流产保胎失败的ROC曲线下面积为0.944,高于各指标单独预测的ROC曲线下面积(P<0.05)。结论经阴道彩色多普勒超声诊断先兆流产有较好的价值,黄体血流PI、RI与血清β-HCG、CA125水平具有一定相关性,联合预测先兆流产保胎失败有一定应用价值。Objective This paper aims to investigate the application of transvaginal color Doppler ultrasonography in the early diagnosis of threatened abortion and its correlation with the serum levels ofβ-chorionic gonadotropin(β-HCG)and carbohydrate antigen-125(CA125).Methods A total of 98 cases of threatened abortion were selected from our hospital from January 2020 to June 2022(observation group),and 100 cases of normal women were selected as control group.The serum levels ofβ-HCG and CA125,and the blood pulsation index(PI)and resistance index(RI)of corpus luteum and uterine artery were compared between the two groups.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of transvaginal color ultrasound in the diagnosis of threatened abortion were 92.86%,100.00%,96.46%,100.00%and 93.46%,respectively.The PI and RI of luteal blood flow in observation group were higher than those in control group(P<0.05).The serumβ-HCG level of the observation group was lower than that of the control group(P<0.05),while the serum CA125 of the observation group was higher than that of the control group(P<0.05).PI and RI of luteal blood flow parameters were negatively correlated withβ-HCG(r=-0.401,r=-0.465,P<0.05),while positively correlated with CA125(r=0.511,r=0.492,P<0.05).PI and RI of luteal blood flow and CA125 inpregnant women with abortive failure of the observation group were higher than those in the successful women(P<0.05),andβ-HCG was lower than the successful parturient women(P<0.05).The area under the ROC curve of PI and RI combined with serumβ-HCG and CA125 in predicting threatened abortion failure was 0.944,which was higher than the ROC curve area predicted by each index alone(P<0.05).Conclusion Transvaginal color Doppler ultrasound has a good value in the diagnosis of threatened abortion.PI and RI of luteal blood flow and the serum levels ofβ-HCG and CA125 are correlated,and this combined prediction of threatened abortion failure has a certain application value.

关 键 词：经阴道彩色多普勒超声 先兆流产 Β-绒毛膜促性腺激素 糖类抗原-125 

分 类 号：R714.21[医药卫生—妇产科学]