超声检查联合BMI、血清β-hCG预测输卵管妊娠甲氨蝶呤保守治疗效果  

Predictive value of the ultrasound examination results combined with the body mass index and the β-human chorionic gonadotropin level for the effect of the conservative treatment of patients with tubal pregnancy by methotrexate

作　　者：许宝全 葛晖[1] 张锋[1] 赵子夜 XU Baoquan;GE Hui;ZHANG Feng;ZHAO Ziy(e The Third People's Hospital of Bengbu,Bengbu Medical University,Bengbu,Anhui Province,233000)

机构地区：[1]蚌埠医科大学附属蚌埠市第三人民医院,233000

出　　处：《中国计划生育学杂志》2024年第11期2606-2610,共5页Chinese Journal of Family Planning

摘　　要：目的:探究超声影像学指标联合体质指数(BMI)、β-人绒毛膜促性腺激素(β-hCG)检测对输卵管妊娠甲氨蝶呤保守治疗效果的预测价值。方法:选取2021年1月-2024年4月本院治疗的120例输卵管妊娠患者,均采用甲氨蝶呤保守治疗。统计保守治疗效果,比较不同疗效患者基线资料,分析输卵管妊娠保守治疗效果的影响因素,受试者工作特征(ROC)评价超声指标联合BMI、血清β-hCG对输卵管妊娠保守治疗效果的预测价值。结果:120例经保守治疗成功76例(成功组)、失败44例(失败组),失败组BMI、附件包块容积、β-hCG及血流平均速度高于成功组,阻力指数低于成功组(均P<0.05);logistic回归分析显示,输卵管妊娠患者BMI、β-hCG及超声指标血流平均速度、附件包块容积、阻力指数均为影响保守治疗效果的因素(均P<0.05);ROC曲线分析,血流平均速度、阻力指数、附件包块容积、BMI、β-hCG预测输卵管妊娠保守治疗效果的曲线下面积(AUC)分别为0.802、0.800、0.754、0.701、0.672,各指标联合预测时AUC为0.960,预测价值最佳。结论:BMI、血清β-hCG及超声指标血流平均速度、阻力指数、附件包块容积均可用于预测输卵管妊娠甲氨蝶呤保守治疗效果,且各指标联合预测效能最高,可为临床治疗方案制定及调整提供参考。Objective:To explore the predictive value of the ultrasound examination results combined with the body mass index(BMI)and the β-human chorionic gonadotropin(β-hCG)level for the effect of the conservative treatment of patients with tubal pregnancy by methotrexate.Methods:A total of 120 patients with tubal pregnancy treated in the hospital from January 2021 to April 2024 were selected in this study.All these patients were given conservative treatment by methotrexate.The effect of the conservative treatment was counted.The baseline data were compared among the patients with the different curative effect.The influencing factors of the effect of the conservative treatment of the tubal pregnancy of these patients were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the ultrasound indicators combined with the BMI and the serum β-hCG level of the patients for the effect of their conservative treatment of tubal pregnancy.Results:After conservative treatment of 120 patients,there were 76 cases with the successful treatment(in group A)and 44 cases with the failed treatment(in group B).The BMI,the adnexal mass volume,the β-hCG level and the average blood flow velocity of the patients in group B were significantly higher than those of the patients in group A,and the blood flow resistance index of the patients in group B was significantly lower than that of the patients in group A(all P<0.05).Logistic regression analysis showed that the BMI,the β-hCG level,and the values of the ultrasound indicators,such as the average blood flow velocity,the adnexal mass volume and the resistance index of the patients with tubal pregnancy were the factors affecting their effect of the conservative treatment(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the average blood flow velocity,the resistance index,the adnexal mass volume,the BMI or the β-hCG level of the patients for predicting the effect of their conservative treatment of the tubal pregnancy was 0.802

关 键 词：输卵管妊娠 甲氨蝶呤 保守治疗效果 超声影像学 体质指数 Β-人绒毛膜促性腺激素 影响因素 预测 

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