血清MIC-1、PAPP-A、β-HCG水平检测联合超声对子宫瘢痕妊娠的诊断价值  

Diagnostic value of serum macrophage inhibitory factor-1,pregnancy-associated plasma protein A and β-human chorionic gonadotropin levels detection combined with ultrasound in uterine scar pregnancy

作　　者：王莉莉 康丽 张春霞 张浩[2] 张蕾[2] 杨玉侠[2] WANG Lili;KANG Li;ZHANG Chunxia;ZHANG Hao;ZHANG Lei;YANG Yuxia(Department of Obstetrics and Gynecology,Zhangjiakou Fifth Hospital,Zhangjiakou 075051,Hebei,China;Department of Obstetrics and Gynecology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]张家口市第五医院妇产科,河北张家口075051 [2]唐山市妇幼保健院妇产科,河北唐山063000

出　　处：《中国性科学》2023年第10期51-55,共5页Chinese Journal of Human Sexuality

基　　金：河北省医学科学研究课题(20221745)。

摘　　要：目的 分析血清巨噬细胞抑制因子-1(MIC-1)、妊娠相关血浆蛋白A(PAPP-A)、β-人绒毛膜促性腺激素(β-HCG)水平检测联合超声对子宫瘢痕妊娠患者的诊断价值。方法 回顾性分析2021年2月至2022年2月在张家口市第五医院就诊的80例子宫瘢痕妊娠患者的临床资料,将其作为观察组,另选取同期同一医院就诊的50例正常孕妇作为对照组。两组均接受血清MIC-1、PAPP-A、β-HCG水平检测和超声检查,比较血清MIC-1、PAPP-A、β-HCG水平检测和超声单独检查与联合检查对子宫瘢痕妊娠的诊断价值。结果 观察组血清MIC-1、PAPP-A、β-HCG水平均低于对照组(P<0.05)。相较于对照组,观察组子宫内膜更厚,附件区包块更大,盆腔积液更深(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,相较于单独检查,血清水平检测联合超声检查对子宫瘢痕妊娠的诊断价值更高,差异具有统计学意义(P<0.05)。相较于单独检查,血清MIC-1、PAPP-A、β-HCG水平检测联合超声检查对子宫瘢痕妊娠诊断的灵敏度、特异度、阳性预测值、阴性预测值及准确度均更高(P<0.05)。结论 血清MIC-1、PAPP-A、β-HCG水平检测联合超声检查在子宫瘢痕妊娠诊断中应用价值较高。Objective To analyze the diagnostic value of serum macrophage inhibitory factor-1(MIC-1),pregnancy-associated plasma protein A(PAPP-A),β-human chorionic gonadotropin(β-HCG)levels detection combined with ultrasound in patients with uterine scar pregnancy.Methods A retrospective analysis was conducted on the clinical data of 80 patients with uterine scar pregnancy who were treated at Zhangjiakou Fifth Hospital from February 2021 to February 2022 and they were selected as the observation group.Another 50 normal pregnant women who were treated at the same hospital during the same period were selected as the control group.Both groups received serum MIC-1,PAPP-A,β-HCG level detection and ultrasound examination,comparing serum MIC-1,PAPP-A,β-HCG level detection and ultrasound alone and combined in uterine scar pregnancy.Results Serum MIC-1,PAPP-Aβ-HCG level in observation group were lower than those of the control group(P<0.05).Compared to the control group,the observation group had thicker endometrium,larger adnexal masses,and deeper pelvic fluid accumulation(P<0.05).The analysis of the receiver operating characteristic(ROC)curve showed that compared to examining alone,serum level detection combined with ultrasound examination had higher diagnostic value for uterine scar pregnancy,and the difference was statistically significant(P<0.05).Compared to examining alone,serum MIC-1,PAPP-A,β-HCG level detection combined with ultrasound examination has higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy in the diagnosis of uterine scar pregnancy(P<0.05).Conclusions Serum MIC-1,PAPP-A,β-HCG level detection combined with ultrasound examination has high application value in the diagnosis of uterine scar pregnancy.

关 键 词：子宫瘢痕妊娠 巨噬细胞抑制因子-1 妊娠相关血浆蛋白A Β-人绒毛膜促性腺激素 超声 

分 类 号：R711[医药卫生—妇产科学]