经阴道彩超联合血清β-HCG早期诊断不典型葡萄胎的临床价值探讨  

Clinical Value of Transvaginal Color Ultrasound Combined with Serumβ-HCG in the Early Diagnosis of Atypical Hydatidiform Mole

作　　者：石朝霞 SHI Zhao-xia(Department of Ultrasound Medicine,Xianning First People's Hospital,Hubei 437000,China)

机构地区：[1]咸宁市第一人民医院超声医学科,湖北437000

出　　处：《影像技术》2024年第3期76-80,共5页Image Technology

摘　　要：目的:探讨分析经阴道彩超联合人绒毛膜促性腺激素(血清β-HCG)早期诊断不典型葡萄胎的临床价值。方法:选取2020年5月-2023年5月我院收治的行阴道超声检查疑似不典型葡萄胎患者60例,所有患者行经阴道彩超检查和血清β-HCG检测,比较患者的血清β-HCG浓度,采用Kappa一致性分析两种方法诊断不典型葡萄胎的临床价值。结果:经过病理学检查,60例患者中32例不典型葡萄胎,28例阴性。不典型葡萄胎组血清β-HCG浓度为(156866.92±6825.32)mIU/ml高于阴性组的血清β-HCG浓度(77138.22±3257.68)mIU/ml,差异有统计学意义(P<0.05);经阴道超声检查诊断不典型葡萄胎32例,其中真阳性21例,误诊11例,漏诊8例;血清β-HCG检测诊断不典型葡萄胎33例,其中真阳性23例,误诊10例,漏诊9例;经阴道超声检查联合血清β-HCG检测诊断不典型葡萄胎41例,其中真阳性30例,误诊11例,漏诊2例;Kappa一致性分析结果显示:经阴道超声检查,灵敏度为68.75%、特异度为64.29%、准确率为66.67%、Kappa值为0.330;血清β-HCG检测,灵敏度为71.88%、特异度为64.29%、准确率为68.33%、Kappa值为0.362;经阴道超声检查联合血清β-HCG检测,灵敏度为93.75%、特异度为60.71%、准确率为78.33%、Kappa值为0.556;联合检查的灵敏度高于经阴道超声检查和血清β-HCG检测,差异有统计学意义(P<0.05)。结论:使用经阴道彩超联合血清β-HCG,可以提高诊断不典型葡萄胎准确率,可以用于临床诊断。Objective:To explore the clinical value of transvaginal color ultrasound combined with human chorionic gonadotropin(serumβ-HCG)in the early diagnosis of atypical hydatidiform mole.Methods:A total of 60 patients with suspected atypical hydatidiform mole admitted to the hospital were enrolled from May 2020 to May 2023.All underwent transvaginal color ultrasonography and serumβ-HCG detection.The concentration of serumβ-HCG in patients was compared.The clinical value of the two methods in the diagnosis of atypical hydatidiform mole was analyzed by Kappa consistency analysis.Results:Pathological examination showed that in the 60 patients,there were 32 cases with atypical hydatidiform mole and 28 negative cases.The concentration of serumβ-HCG in atypical hydatidiform mole group was higher than that in negative group[(156866.92±6825.32)mIU/ml vs(77138.22±3257.68)mIU/ml,P<0.05].Transvaginal ultrasonography diagnosed 32 patients with atypical hydatidiform mole,including 21 cases with true positive,11 cases with misdiagnosis and 8 cases with missed diagnosis.Serumβ-HCG detection diagnosed 33 patients with atypical hydatidiform mole,including 23 cases with true positive,10 cases with misdiagnosis and 9 cases with missed diagnosis.Transvaginal ultrasonography combined with serumβ-HCG detection diagnosed 41 patients with atypical hydatidiform mole,including 30 cases with true positive,11 cases with misdiagnosis and 2 cases with missed diagnosis.The results of Kappa consistency analysis showed that sensitivity,specificity,accuracy,and Kappa values of transvaginal ultrasound,serumβ-HCG detection and combined detection were(68.75%,64.29%,66.67%,0.330),(71.88%,64.29%,68.33%,0.362)and(93.75%,60.71%,78.33%,0.556),respectively.The sensitivity of combined detection was higher than that of single method(P<0.05).Conclusion:Transvaginal color ultrasound combined with serumβ-HCG can improve the diagnostic accuracy rate of atypical hydatidiform mole,which can be applied in clinical diagnosis.

关 键 词：经阴道彩超 人绒毛膜促性腺激素 不典型葡萄胎 

分 类 号：R711.7[医药卫生—妇产科学]