β-hCG、hPL mRNA联合彩色多普勒超声对凶险性前置胎盘合并胎盘植入的诊断价值  

Diagnostic value of serum freeβchorionic gonadotropin and plasma human placental prolactin mRNA combined with color Doppler ultrasound in the diagnosis of dangerous placenta previa with placental implantation

作　　者：杨海阳 袁翱龙 夏丽娜[1] YANG Haiyang;YUAN Aolong;XIA Lina(Laboratory of Luohe Central Hospital,Luohe 462300,China;Obstetrics and Gynecology of Luohe Central Hospital,Luohe 462300,China)

机构地区：[1]河南省漯河市中心医院检验科,河南漯河462300 [2]河南省漯河市中心医院产科,河南漯河462300

出　　处：《医学影像学杂志》2025年第3期82-86,共5页Journal of Medical Imaging

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20191420)。

摘　　要：目的 探究血清游离β绒毛膜促性腺激素(β-hCG)、血浆人胎盘催乳素(hPL)mRNA水平联合彩色多普勒超声在凶险性前置胎盘(PPP)合并胎盘植入诊断中的临床价值。方法 选取本院收治的PPP患者96例,分为胎盘植入组51例和无胎盘植入组45例,另选取同期健康孕妇57例作为对照组。利用三维彩色多普勒超声对患者进行诊断;采用电化学发光法检测血清β-hCG水平;northern blot检测患者血浆中hPL mRNA水平;采用受试者工作特征(ROC)曲线分析血清β-hCG和血浆hPL mRNA水平对PPP合并胎盘植入的诊断价值;采用Kappa检验分析血清β-hCG、血浆hPL mRNA水平联合彩色多普勒超声对PPP合并胎盘植入诊断的一致性。结果 与对照组相比,PPP组患者血清β-hCG及血浆hPL mRNA水平升高,差异有统计学意义(P<0.05);与无胎盘植入组相比,胎盘植入组患者血清β-hCG及血浆hPL mRNA水平升高,差异有统计学意义(P<0.05);且PPP患者发生胎盘植入与剖宫产次和宫内感染有关(P<0.05)。ROC曲线分析结果显示,血清β-hCG和血浆hPL mRNA水平单独诊断PPP合并胎盘植入的曲线下面积(AUC)为0.850、0.849;彩色多普勒超声、血清β-hCG、血浆hPL mRNA水平及三者联合诊断的灵敏度分别为72.55%、82.35%、90.20%,特异度为84.44%、82.22%、84.44%;Kappa一致性分析发现,彩色多普勒超声和血清β-hCG水平单独诊断PPP合并胎盘植入与金标准结果中度一致(Kappa=0.563、0.565),血清hPL mRNA水平单独诊断及三者联合诊断PPP合并胎盘植入与金标准结果一致性较高(Kappa=0.645、0.748)。结论 血清β-hCG、血浆hPL mRNA水平在PPP合并胎盘植入患者中均升高,且两者联合彩色多普勒超声对PPP合并胎盘植入具有一定的临床诊断价值。Objective To explore the clinical value of serum freeβ-chorionic gonadotropin(β-hCG),plasma human pla⁃cental prolactin(hPL)mRNA levels and color Doppler ultrasound in the diagnosis of dangerous placenta praevia(PPP)with pla⁃centa accreta.Methods 96 PPP patients admitted to our hospital were collected as the study subjects,and were grouped into a placental accreta group of 51 cases and a non placental accreta group of 45 cases.Additionally,57 healthy pregnant women were as the control group.Color Doppler ultrasound was applied to diagnose patients;Electrochemiluminescence method was applied to detect serum β-hCG level;Northern blot was applied to detect hPL mRNA level in plasma;receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum β-hCG and plasma hPL levels for PPP combined with placen⁃tal accreta;and Kappa test was applied to analyze the consistency of serum β-hCG and plasma hPL mRNA levels combined with color Doppler ultrasound in the diagnosis of PPP complicated with placenta accreta.Results Compared with the control group,the level of serum β-hCG and plasma hPL mRNA in the PPP group increased(P<0.05);compared with the non placental ac⁃creta group,the level of serum β-hCG and plasma hPL mRNA in the placental accreta group increased(P<0.05);and placental implantation in PPP patients was related to cesarean section times and intrauterine infection(P<0.05).Receiver operating char⁃acteristic analysis showed that the area under the curve(AUC)of serum β-hCG level and plasma hPL mRNA level separately diagnosed PPP with placental accreta was 0.850 and 0.849;the sensitivity of color ultrasound,serum β-hCG,plasma hPL mRNA levels,and their combined diagnosis was 72.55%,82.35%,and 90.20%,while the specificity was 84.44%,82.22%,and 84.44%;Kappa consistency analysis found that color Doppler ultrasound and serumβ-hCG levels independently diagnosed PPP with placental accreta were moderately consistent with the gold standard results(Kappa=0.563、0.565),the serum h

关 键 词：凶险性前置胎盘 胎盘植入 游离β绒毛膜促性腺激素 人胎盘催乳素 超声诊断 

分 类 号：R714.2[医药卫生—妇产科学] R445.1[医药卫生—临床医学]