经阴道超声联合血β-绒毛膜促性腺激素、孕酮诊断异位妊娠的价值  

Value of transvaginal ultrasound combined with β-human chorionic gonadotrophin and progesterone in diagnosis of ectopic pregnancy

作　　者：张璐 段莹莹 邵敏 Zhang Lu;Duan Yingying;Shao Min(Department of Ultrasound,Puyang Maternity and Child Care Centers,Puyang 457000,China)

机构地区：[1]濮阳市妇幼保健院超声科,濮阳457000

出　　处：《中国实用医刊》2024年第3期93-96,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨经阴道超声联合血β-绒毛膜促性腺激素(β-HCG)、孕酮诊断异位妊娠的性能。方法抽取2019年5月至2021年4月濮阳市妇幼保健院收治的异位妊娠患者68例作为研究组,并以1∶1配比抽取同期正常妊娠者68例作为对照组。两组均进行经阴道超声检查及β-HCG、孕酮检测。比较两组β-HCG、孕酮水平,统计单项(β-HCG、孕酮、经阴道超声)及三项联合对异位妊娠的诊断结果、诊断效能、预测值。结果研究组β-HCG、孕酮水平低于对照组(P<0.05)。68例异位妊娠患者和68例正常妊娠孕妇中,β-HCG诊断出异位妊娠55例,正常妊娠51例;孕酮诊断出异位妊娠54例,正常妊娠52例;经阴道超声诊断出异位妊娠48例,正常妊娠50例;三项联合诊断出异位妊娠63例,正常妊娠64例。单项诊断(β-HCG、孕酮、经阴道超声)灵敏性(80.88%,55/68;79.41%,54/68;70.59%,48/68)、特异性(75.00%,51/68;76.47%,52/68;73.53%,50/68)、准确性(77.94%,106/136;77.94%,106/136;72.06%,98/136)低于三项联合诊断(92.65%,63/68;94.12%,64/68;93.38%,127/136),漏诊率(19.12%,13/68;20.59%,14/68;29.42%,20/68)、误诊率(25.00%,7/68;23.53%,16/68;26.47%,18/68)高于三项联合诊断(7.35%,5/68;5.88%,4/68),差异有统计学意义(P<0.05)。单项诊断(β-HCG、孕酮、经阴道超声)阳性预测值(76.39%,55/72;77.14%,54/70;72.73%,48/66)、阴性预测值(79.69%,51/64;76.47%,52/68;71.43%,50/70)低于三项联合诊断(94.03%,63/67;92.75%,64/69),差异有统计学意义(P<0.05)。结论经阴道超声联合β-HCG、孕酮应用于异位妊娠诊断中,能提高诊断灵敏性、特异性和准确性,减少漏诊和误诊的发生,且预测值良好。Objective To investigate the efficacy of transvaginal ultrasound combined withβ-human chorionic gonadotrophin(β-HCG)and progesterone in diagnosis of ectopic pregnancy.Methods A total of 68 patients with ectopic pregnancy admitted to Puyang Maternity and Child Care Centers from May 2019 to April 2021 were selected as the study group,and 68 cases with normal pregnancy in the same period were selected as the control group with a ratio of 1∶1.Vaginal ultrasound,β-HCG and progesterone testings were performed in both groups.The levels ofβ-HCG and progesterone in the two groups were compared.And the diagnostic results,diagnostic efficacy and predictive value ofβ-HCG,progesterone,transvaginal ultrasound and combination of the them for ectopic pregnancy were counted.Results The levels ofβ-HCG and progesterone in the study group were lower than those in the control group(P<0.05).Among the 68 women with ectopic pregnancies and 68 cases of normal pregnancy,β-HCG testing identified 55 cases of ectopic pregnancy and 51 cases of normal pregnancy;progesterone testing identified 54 cases of ectopic pregnancy and 52 cases of normal pregnancy;transvaginal ultrasound confirmed 48 cases of ectopic pregnancy and 50 cases of normal pregnancy;and the combination of the three examinations identified 63 cases of ectopic pregnancy and 64 cases of normal pregnancy.The sensitivity ofβ-HCG(80.88%,55/68),progesterone(79.41%,54/68)and transvaginal ultrasound(70.59%,48/68)were lower than that of the combination of the three(92.65%,63/68)in the diagnosis of ectopic pregnancy(P<0.05).The specificity ofβ-HCG(75.00%,51/68),progesterone(76.47%,52/68)and transvaginal ultrasound(73.53%,50/68)were lower than that of the combination of the three(94.12%,64/68),P<0.05.The accuracy ofβ-HCG(77.94%,106/136),progesterone(77.94%,106/136)and transvaginal ultrasound(72.06%,98/136)were lower than that of the combination of the three(93.38%,127/136),P<0.05.The missed diagnosis rate ofβ-HCG(19.12%,13/68),progesterone(20.59%,14/68)and transvaginal ultras

关 键 词：异位妊娠 Β-绒毛膜促性腺激素 孕酮 经阴道超声 

分 类 号：R714.22[医药卫生—妇产科学] R445.1[医药卫生—临床医学]