经会阴盆底超声联合血清sMFAP4、LTBP-2对产后盆底功能障碍性疾病的临床诊断价值  

Clinical diagnostic value of transperineal pelvic floor ultrasound combined with serum sMFAP4 and LTBP-2 for postpartum pelvic floor dysfunction

作　　者：刘英 于水昌 杨红芳[2] LIU Ying;YU Shuichang;YANG Hongfang(Department of Ultrasound Imaging,the Fourth Hospital of Cangzhou,Cangzhou,Hebei 061000,China;Department of Laboratory Medicine,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省沧州市第四医院超声影像科,河北沧州061000 [2]河北医科大学第四医院检验科,河北石家庄050000

出　　处：《检验医学与临床》2025年第6期773-777,共5页Laboratory Medicine and Clinic

基　　金：河北省中医药管理局2024年度中医药类科学研究课题计划项目(2024183)。

摘　　要：目的探讨经会阴盆底超声联合血清可溶性微纤维相关蛋白4(sMFAP4)、潜在转化生长因子结合蛋白-2(LTBP-2)对产后盆底功能障碍性疾病(PFD)的临床诊断价值。方法选取2020年10月至2023年6月在沧州市第四医院确诊的107例PFD患者作为PFD组,包括尿失禁48例、盆腔脏器脱垂25例、慢性盆腔疼痛10例、肠功能障碍15例、性功能障碍9例;另选取同期在沧州市第四医院产后检查无PFD的健康女性志愿者103例作为对照组。采用彩色多普勒超声诊断仪对2组进行经会阴盆底超声检测,并测量肛提肌裂孔面积、膀胱尿道后角、膀胱颈移动度、尿道旋转角。分别采用磁分离均相酶联免疫定量测定技术和酶联免疫吸附试验测定血清sMFAP4、LTBP-2水平。绘制受试者工作特征(ROC)曲线分析超声相关参数及血清sMFAP4、LTBP-2对产后PFD的临床诊断价值。结果与对照组相比,PFD组肛提肌裂孔面积、膀胱尿道后角、膀胱颈移动度、尿道旋转角均显著增加(P<0.05),血清sMFAP4、LTBP-2水平均显著降低(P<0.05)。尿失禁、盆腔脏器脱垂、慢性盆腔疼痛、肠功能障碍、性功能障碍患者血清sMFAP4、LTBP-2水平比较,差异均无统计学意义(P>0.05)。肛提肌裂孔面积、膀胱尿道后角、膀胱颈移动度、尿道旋转角、血清sMFAP4、血清LTBP-2单独及联合诊断产后PFD的曲线面积(AUC)分别为0.764(95%CI:0.701~0.828)、0.802(95%CI:0.743~0.861)、0.764(95%CI:0.699~0.828)、0.830(95%CI:0.776~0.884)、0.799(95%CI:0.738~0.859)、0.773(95%CI:0.707~0.838)、0.978(95%CI:0.962~0.994),6项指标联合诊断产后PFD的AUC大于肛提肌裂孔面积、膀胱尿道后角、膀胱颈移动度、尿道旋转角、sMFAP4、LTBP-2单独诊断的AUC(Z=6.488、5.669、6.302、5.256、5.591、6.037,P均<0.001)。结论血清sMFAP4、LTBP-2水平在产后PFD患者中均下调,经会阴盆底超声检测联合血清sMFAP4、LTBP-2对产后PFD有一定诊断价值,且联合诊断产后PFD的价Objective To investigate the clinical diagnostic value of transperineal pelvic floor ultrasound combined with serum soluble microfiber associated protein 4(sMFAP4)and latent transforming growth factor beta binding protein 2(LTBP-2)for postpartum pelvic floor dysfunction(PFD).Methods From October 2020 to June 2023,107 PFD patients diagnosed in the Fourth Hospital of Cangzhou were regarded as the PFD group,including 48 cases with urinary incontinence,25 cases with pelvic organ prolapse,10 cases with chronic pelvic pain,15 cases with intestinal dysfunction and 9 cases with sexual dysfunction.Another 103 healthy volunteers with no PFD after postpartum examination in the Fourth Hospital of Cangzhou during the same period were selected as the control group.Color Doppler ultrasound was used to detect the perineal pelvic floor of the two groups,and the hiatus area of levator ani muscle,the posterior angle of the bladder urethra,the mobility of the bladder neck and the rotation angle of the urethra were measured.The levels of serum sMFAP4 and LTBP-2 were determined by magnetic separation homogeneous enzyme-linked immunoquantitative assay technique and enzyme-linked immunosorbent assay,respectively.Receiver operating characteristic(ROC)curve was drawn to analyze the clinical diagnostic value of ultrasound parameters and serum sMFAP4 and LTBP-2 in postpartum PFD.Results Compared with the control group,the hiatus area of levator ani muscle,posterior angle of bladder urethra,bladder neck mobility and urethral rotation angle in the PFD group were obviously increased(P<0.05),while serum levels of sMFAP4 and LTBP-2 were obviously reduced(P<0.05).There was no statistically obvious differences in serum sMFAP4 and LTBP-2 levels among patients with urinary incontinence,pelvic organ prolapse,chronic pelvic pain,intestinal dysfunction and sexual dysfunction(P>0.05).The areas under the curve(AUC)for the diagnosis of postpartum PFD of the hiatus area of levator ani muscle,posterior vesicourethral angle,bladder neck mobility,urethral rot

关 键 词：经会阴盆底超声 可溶性微纤维相关蛋白4 潜在转化生长因子结合蛋白-2 产后盆底功能障碍性疾病 诊断 

分 类 号：R711[医药卫生—妇产科学] R493[医药卫生—临床医学]