经阴道超声联合血清PAPP-A、β-hCG、INHA诊断异位妊娠的临床价值  

Clinical value of transvaginal ultrasonography combined with serum PAPP-A,β-HCG and INHA in diagnosing ectopic pregnancy

作　　者：陈朝霞 王小飞 李莹 CHEN Chao-xia;WANG Xiao-fei;LI Ying(Department of Gynaecology and Obstetrics,Dazhou Integrated TCM&Western Medicine Hospital,Dazhou Sichuan 635000,China;Department of Reproduction Center,Chengdu Jinjiang District Maternal and Child Health Care Hospital,Chengdu Sichuan 610000,China)

机构地区：[1]达州市中西医结合医院妇产科,四川达州635000 [2]成都市锦江区妇幼保健院生殖中心,四川成都610000

出　　处：《临床和实验医学杂志》2023年第15期1668-1670,共3页Journal of Clinical and Experimental Medicine

基　　金：四川省科技计划项目(编号:2019SJ001216)。

摘　　要：目的研究经阴道超声联合血清妊娠相关蛋白-A(PAPP-A)、人绒毛膜促性腺激素(β-hCG)、抑制素A(INHA)诊断异位妊娠的临床价值。方法前瞻性选择2019年1月至2021年12月于达州市中西医结合医院接受诊断的疑似异位妊娠患者90例纳入研究组,选择同期行健康体检的90名正常妊娠孕妇纳入对照组。两组均行经阴道超声检查,比较两组血清PAPP-A、β-hCG、INHA水平;研究组经病理诊断与经阴道超声诊断异位妊娠情况。以手术病理诊断结果为金标准,分析研究组经阴道超声及血清PAPP-A、β-hCG、INHA单独与联合诊断异位妊娠的敏感度、特异度、阳性预测值、阴性预测值等诊断效能。结果研究组血清PAPP-A、β-hCG、INHA水平分别为(9.85±1.16)mIU/mL、(998.65±105.06)mIU/mL、(18.95±2.24)pg/mL,均低于对照组[(3.97±0.42)mIU/mL、(1587.98±170.25)mIU/mL、(53.64±5.73)pg/mL],差异均有统计学意义(P<0.05)。研究组经病理诊断与经阴道超声诊断异位妊娠情况差异无统计学意义(P>0.05)。经阴道超声联合血清PAPP-A、β-hCG、INHA诊断异位妊娠的敏感度、特异度、阳性预测值、阴性预测值等诊断效能均高于其单独、两两、三三联合。结论异位妊娠患者血清PAPP-A、β-hCG、INHA水平显著低于正常孕妇,经阴道超声联合血清PAPP-A、β-hCG、INHA对异位妊娠具有较高的诊断价值。Objective To study the clinical value of Transvaginal ultrasonography combined with serum pregnancy-associated protein-A(PAPP-A),human chorionic gonadotropin(β-HCG),inhibin A(INHA)in the diagnosis of ectopic pregnancy.Methods Perspective select 90 PATIENTS with suspected ectopic pregnancy diagnosed in Dazhou Integrated TCM&Western Medicine Hospital from January 2019 to December 2021 were included in the study group and 90 normal pregnant women who underwent physical examination in our hospital during the same period were included in the control group.Both groups underwent transvaginal ultrasound examination.The levels of serum PAPP-A,β-HCG and INHA were compared between the two groups.The ectopic pregnancy in the study group was diagnosed by pathological diagnosis and transvaginal ultrasound.The diagnostic efficacy such as sensitivity,specificity,positive predictive value,and negative predictive value of transvaginal ultrasound and serum PAPP-A,β-HCG and INHA in the study group was compared with the gold standard of surgical pathological diagnosis.Results The levels of PAPP-A,β-HCG and INHA in the study group were(9.85±1.16)mIU/mL,(998.65±105.06)mIU/mL,(18.95±2.24)pg/mL,respectively,which were lower than those in the control group[(3.97±0.42)mIU/mL,(1587.98±170.25)mIU/mL,(53.64±5.73)pg/mL],the differences were statistically significant(P<0.05).There was no statistically significant difference in the transvaginal pathological diagnosis and transvaginal ultrasound(P>0.05).The diagnostic efficacy such as sensitivity,specificity,positive predictive value,and negative predictive value of transvaginal ultrasound combined with PAPP-A,β-HCG and INHA for ectopic pregnancy were higher than those of PAPP-A,β-HCG and INHA alone.Conclusion The serum levels of PAPP-A,β-HCG and INHA in ectopic pregnancy patients are significantly lower than those in normal pregnant women.Transvaginal ultrasonography combined with PAPP-A,β-HCG and INHA has high diagnostic value for ectopic pregnancy.

关 键 词：经阴道超声 妊娠相关蛋白-A 人绒毛膜促性腺激素 抑制素A 异位妊娠 诊断 

分 类 号：R714.22[医药卫生—妇产科学]