血清HCG表达水平联合MRI对凶险性前置胎盘穿透型的预测价值  

Value of Serum HCG Expression Level Combined with MRI in Predicting the Penetration of Dangerous Placenta Previa

作　　者：郑红艳 查冰杰 张秀珍 巩军 ZHENG Hongyan;ZHA Bingjie;ZHANG Xiuzhen;GONG Jun(Obstetrics and Gynecology Department,Xuchang Maternal and Child Health Hospital,Xuchang 461000,China)

机构地区：[1]许昌市妇幼保健院妇产科,河南许昌461000

出　　处：《河南医学研究》2025年第7期1297-1300,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191390)。

摘　　要：目的探究血清人绒毛膜促性腺激素(HCG)表达水平联合核磁共振成像(MRI)对凶险性前置胎盘穿透型的预测价值。方法收集许昌市妇幼保健院2020年1月至2023年6月收治的156例凶险性前置胎盘患者临床资料。依照是否为穿透型分为穿透型组(52例)以及非穿透型组(104例)。组织病理结果为“金标准”。两组均进行MRI检查及血清HCG表达水平的测定。比较血清HCG表达水平、MRI检测结果、血清HCG表达水平联合MRI对凶险性前置胎盘穿透型的预测价值以及3种不同病理分型的凶险性前置胎盘血清HCG表达水平。结果穿透型组与非穿透型组的年龄、体重指数、孕周比较,差异无统计学意义(P>0.05)。穿透型组HCG水平高于非穿透型组(P<0.001)。3种不同病理分型的凶险性前置胎盘血清HCG表达水平差异有统计学意义(P<0.001),穿透型HCG表达水平高于植入型、粘连型(P<0.001)。MRI检测出54例阳性(穿透型),102例阴性(非穿透型)。HCG、MRI以及二者联合的曲线下面积(AUC)为0.992、0.990、0.998,灵敏度分别为0.942、1.000、1.000,特异度分别为0.990、0.981、0.981,二者联合的AUC最大,灵敏度、特异度较高,诊断效能最好。结论血清HCG表达水平联合MRI对凶险性前置胎盘穿透型有良好的预测价值,可以作为临床上凶险性前置胎盘穿透型的诊断依据之一。Objective To explore the predictive value of serum human chorionic gonadotropin(HCG)expression level combined with magnetic resonance imaging(MRI)in dangerous placental previa penetration.Methods Clinical data of 156 patients with dangerous placenta previa admitted to Xuchang Maternal and Child Health Hospital from January 2020 to June 2023 were collected.They were divided into penetrating group(52 cases)and non-penetrating group(104 cases).The histopathological results were“gold standard”.MRI examination and serum HCG expression were performed in both groups.The serum HCG expression level,MRI detection results,the predictive value of serum HCG expression level combined with MRI in penetrating type of dangerous placenta previa,and the serum HCG expression level in three different pathological types of dangerous placenta previa were compared.Results There was no significant difference in age,body mass index and gestational age between penetrating group and non-penetrating group(P>0.05).HCG level in penetrating group was higher than that in non-penetrating group(P<0.001).There were significant differences in serum HCG expression in the three types of dangerous placenta previa(P<0.001),and the expression level of HCG in penetrating type was higher than that in implantation type and adhesion type(P<0.001).MRI detected 54 positive(penetrating type)and 102 negative(non-penetrating type)cases.The area under the curve(AUC)of HCG,MRI and their combination were 0.992,0.990,0.998,the sensitivity were 0.942,1.000,1.000,and the specificity were 0.990,0.981,0.981,respectively.The AUC of HCG,MRI and their combination was the largest,the sensitivity and specificity were high,and the diagnostic efficiency was the best.Conclusion Serum HCG expression level combined with MRI has a good predictive value for the dangerous penetrant type of placenta previa,and can be used as one of the diagnostic bases for the dangerous penetrant type of placenta previa in clinic.

关 键 词：凶险性前置胎盘 穿透型 人绒毛膜促性腺激素 核磁共振成像 

分 类 号：R714.56[医药卫生—妇产科学]