宫颈弹性成像参数联合孕晚期血清HCG预测双胎妊娠自发性早产的效能分析  

Efficacy analysis of cervical elastography parameters combined with late pregnancy serum HCG in predicting spontaneous preterm delivery of twin pregnancy

作　　者：杨静 吕小英 马馨玉 叶锦美 YANG Jing;LYU Xiaoying;MA Xinyu;YE Jinmei(Functional Department of Huizhou Sixth People's Hospital,Huizhou,Guangdong 516200,China)

机构地区：[1]惠州市第六人民医院功能科,广东惠州516200

出　　处：《安徽医药》2025年第4期700-705,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨宫颈弹性成像参数联合孕晚期血清人绒毛膜促性腺激素(HCG)预测双胎妊娠自发性早产的效能。方法选取2017年1月至2023年3月在惠州市第六人民医院产检的132例孕晚期双胎妊娠孕妇设为研究组,另选取同期在该院体检的132例同孕周单胎妊娠孕妇设为对照组,两组行宫颈弹性成像超声检查和血清HCG水平检测并比较。随访至生产,根据妊娠结局将研究组病人分为早产组(n=62)和足月产组(n=70),比较两组孕妇的宫颈弹性成像参数[弹性对比指数(ECI)、宫颈内口应变值(IOS)、宫颈外口应变值(EOS)、硬度比值(HR)]和血清HCG水平。采用logistic回归分析法分析双胎妊娠自发性早产的影响因素,另采用受试者操作特征曲线(ROC曲线)分析宫颈弹性成像参数联合孕晚期血清HCG对双胎妊娠自发性早产的预测价值。结果研究组的ECI(4.08±0.59比3.62±0.54)、IOS[0.34(0.28,0.40)比0.28(0.22,0.36)]、EOS[0.35(0.32,0.39)比0.30(0.26,0.37)]及血清HCG水平[(31606.57±5416.54)IU/L比(23537.62±4635.07)IU/L]均高于对照组(P<0.05),HR低于对照组(P<0.05);早产组的ECI、IOS、EOS及血清HCG水平均高于足月产组,HR低于足月产组(P<0.05)。logistic回归分析结果显示,单绒毛膜性双胎、阴道炎、ECI、IOS、EOS、HR及血清HCG水平均为双胎妊娠自发性早产的影响因素(OR=2.16、2.13、1.87、2.03、1.66、0.58、1.62,P<0.05)。ECI、IOS、EOS、HR联合预测的灵敏度、曲线下面积(AUC)、特异度分别为79.03%、0.86、84.29%,其中特异度、AUC均高于单项参数预测(P<0.05),灵敏度与单项参数预测相差较小。宫颈弹性成像参数和孕晚期血清HCG联合预测的灵敏度、AUC、特异度分别为95.16%、0.93、78.57%,其中灵敏度、AUC均高于单独预测(P<0.05),特异度与单独预测相差较小。结论与足月产孕妇相比,双胎妊娠自发性早产孕妇的ECI、IOS、EOS及孕晚期血清HCG更高,HR更低,且以上指标均为双胎妊娠自�Objective To explore the efficacy of cervical elastography parameters combined with late pregnancy serum human chorionic gonadotropin(HCG)in predicting spontaneous preterm delivery of twin pregnancy.Methods A total of 132 late pregnancy twin pregnant women who underwent prenatal examination at Huizhou Sixth People's Hospital from January 2017 to March 2023 were selected as the research group,and 132 single pregnancy pregnant women of the same gestational week who underwent physical examination in Huizhou Sixth People's Hospital during the same period were selected as the control group,and the cervical elastography ultrasound examination and serum HCG level detection were performed and compared between the two groups.Followed up until delivery,the research group patients were divided into premature delivery group(n=62)and term delivery group(n=70)based on pregnancy outcomes.The cervical elastography parameters[elasticity contrast index(ECI),internal os strain(IOS),external os strain(EOS),hardness ratio(HR)]and serum HCG level were compared between two groups of pregnant women.The influencing factor of spontaneous premature delivery in twin pregnancies was analyzed by using Logistic regression analysis,and the predictive value of cervical elastography parameters combined with late pregnancy serum HCG for spontaneous preterm delivery in twin pregnancy was analyzed by using the receiver operating characteristic curve(ROC curve).Results The ECI[(4.08±0.59)vs.(3.62±0.54)],IOS[0.34(0.28,0.40)vs.0.28(0.22,0.36)],EOS[0.35(0.32,0.39)vs.0.30(0.26,0.37)]and serum HCG level[(31606.57±5416.54)IU/L vs.(23537.62±4635.07)IU/L]in the research group were higher than those in the control group(P<0.05),while HR was lower than that in the control group(P<0.05).The ECI,IOS,EOS and serum HCG level in the premature delivery group were higher than those in the term delivery group,while HR was lower than that in the term delivery group(P<0.05).The results of Logistic regression analysis showed that single chorionic twin,vaginitis,ECI,I

关 键 词：妊娠 双胎 宫颈弹性成像 人绒毛膜促性腺激素 早产 预测价值 

分 类 号：R714.21[医药卫生—妇产科学]