血清MIC-1、PAPP-A联合超声造影对瘢痕妊娠的诊断价值  

Evaluation of diagnostic value of serum MIC-1,PAPP-A combined with contrast-enhanced ultrasound in pregnant women with cicatricial pregnancy

作　　者：杨艳丽 赵维英[1] 叶健[2] YANG Yan-li;ZHAO Wei-ying;YE Jian(Department of Obstetrics and Gynecology,Jiangbei Hospital,Zhongda Hospital Affiliated to Southeast University,Nanjing Jiangsu 210044,China.;Department of Laboratory,Jiangbei Hospital,Zhongda Hospital Affiliated to Southeast University,Nanjing Jiangsu 210044,China.)

机构地区：[1]东南大学附属中大医院江北院区妇产科,江苏南京210044 [2]东南大学附属中大医院江北院区检验科,江苏南京210044

出　　处：《临床和实验医学杂志》2023年第19期2077-2080,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省临床重点专科建设项目(编号:2011873)。

摘　　要：目的 探讨血清巨噬细胞抑制因子-1(MIC-1)、妊娠相关蛋白-A(PAPP-A)联合超声造影对瘢痕妊娠的诊断价值评估。方法 回顾性分析2020年6月至2021年12月东南大学附属中大医院江北院区接诊的135例瘢痕妊娠患者的临床病理资料,按照瘢痕妊娠发生情况,将发生瘢痕妊娠分为病例组(n=52),未发生瘢痕妊娠分为对照组(n=83)。分析测定各组受试者血清MIC-1、PAPP-A浓度;记录各组超声造影诊断结果[峰值强度(PST)、达峰时间(PIT)、胰腺实质始增时间(SLPT)];采用受试者工作特征(ROC)曲线分析血清MIC-1、PAPP-A和超声造影对瘢痕妊娠患者的诊断价值。结果 病例组患者血清MIC-1、PAPP-A水平分别为(0.54±0.12) g/L、(5.41±0.78) ng/mL,均显著低于对照组[(1.05±0.42) g/L、(9.69±1.79) ng/mL],差异均有统计学意义(P<0.05)。病例组患者超声造影PST、PIT、SLPT水平分别(43.16±1.23) dB、(40.42±1.23) s、(12.24±1.26) s,均显著低于对照组[(50.47±1.45) dB、(55.86±1.58) s、(19.45±1.08) s],差异均有统计学意义(P<0.05)。与临床诊断比较,超声造影诊断准确率为96.15%,比较差异无统计学意义(P>0.05)。ROC结果显示,血清MIC-1、PAPP-A、超声造影参数及联合检测预测瘢痕妊娠的曲线下面积(AUC)分别为0.913、0.991、0.962、0.982、0.920、0.999,截断值分别为0.78 g/L、6.93 ng/mL、47.15 dB、48.56 s、15.48 s,联合检测的特异度、准确度较单独检测更高(P<0.05)。结论 超声造影检查和血清MIC-1、PAPP-A联合诊断瘢痕妊娠的灵敏度高于各项单独诊断,联合检测对瘢痕妊娠的诊断有一定的临床价值。Objective To study evaluation of diagnostic value of serum Macrophage inhibitory factor-1(MIC-1),pregnancy-associated protein-A(PAPP-A)combined with contrast-enhanced ultrasound in pregnant women with cicatricial pregnancy.Methods The clinicpathological data of 135 pregnant women admitted to Jiangbei Hospital,Zhongda Hospital Affiliated to Southeast University from June 2020 to December 2021 were retrospectively analyzed.According to the occurrence of scar pregnancy,they were divided into case group(n=52)and control group(n=83).The serum MIC-1 and PAPP-A concentrations of subjects in each group were analyzed and determined.The diagnostic results of contrast-enhanced ultrasound[peak strength(PST),peak time(PIT),substantial start time(SLPT)]in each group were recorded.The diagnostic value of serum MIC-1,PAPP-A and contrast-enhanced ultrasound was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum MIC-1 and PAPP-A in case group were(0.54±0.12)g/L,(5.41±0.78)ng/mL,respectively,which were significantly lower than those in control group[(1.05±0.42)g/L,(9.69±1.79)ng/mL],the differences were statistically significant(P<0.05).The levels of PST,PIT and SLPT in case group were(43.16±1.23)dB,(40.42±1.23)s,(12.24±1.26)s,respectively,which were significantly lower than those in control group[(50.47±1.45)dB,(55.86±1.58)s,(19.45±1.08)s],the differences were statistically significant(P<0.05).Compared with clinical diagnosis,the accuracy of contrast-enhanced ultrasound diagnosis was 96.15%,and the difference was not statistically significant(P>0.05).According to the results of ROC,serum MIC-1,PAPP-A,contrast-enhanced ultrasound parameters and joint detection predict the area under the curve(AUC)scar pregnancy were 0.913,0.991,0.962,0.982,0.920,0.999,cut-off value were 0.78 g/L,6.93 ng/mL,47.15 dB,48.56 s and 15.48 s,the specificity and accuracy of combined detection were higher than those of single detection(P<0.05).Conclusion The sensitivity of contrast ultrasonography combined with seru

关 键 词：妊娠 异位 巨噬细胞抑制因子-1 妊娠相关蛋白-A 超声造影 诊断价值 

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]