摘要
目的探讨血清人绒毛膜促性腺激素(β-HCG)比值、孕酮和子宫内膜厚度单独及联合检测对异位妊娠的预测价值。方法回顾性分析300例因疑似"异位妊娠"入院,而后被证实为异位妊娠患者或宫内妊娠者的临床资料,采用受试者工作特征(ROC)曲线和Logistic回归方程分析并确定血清β-HCG比值、孕酮和子宫内膜厚度单独检测时的预测界值,评估各指标单独及联合检测对预测异位妊娠的敏感性和特异性。结果异位妊娠组血清β-HCG比值、孕酮及子宫内膜厚度均显著低于正常妊娠组(P<0.001)。单独使用血清β-HCG比值、孕酮和子宫内膜厚度预测异位妊娠:当孕酮的界值为55.3 nmol/L时,其敏感性为90.4%,特异性为78.6%;当β-HCG比值的界值为2.01时,其敏感性为86.5%,特异性为83.9%;当子宫内膜厚度的界值为11.5 mm时,其敏感性为86.5%,特异性为60.7%。3个指标联合预测异位妊娠的敏感性为94.6%,特异性为88.5%。各指标单独和联合检测的ROC曲线的曲线下面积分别为:血清β-HCG比值0.852,孕酮0.845,子宫内膜厚度0.736,孕酮与子宫内膜厚度联合检测0.887,血清β-HCG比值与孕酮联合检测0.868,血清β-HCG比值与子宫内膜厚度联合检测0.867,3个指标联合检测0.950。结论联合使用血清β-HCG比值、孕酮和子宫内膜厚度对异位妊娠进行预测,可更有效地提高异位妊娠的早期诊断率。
Objective To investigate the roles of single and combined determinations of serum human chorionic gonadotropin（β-HCG） ratio,progesterone and endometrial thickness for predicting ectopic pregnancy. Methods A total of 300 suspected patients with ectopic pregnancy were enrolled,they were proved to be ectopic pregnancy or intrauterine pregnancy later,and their clinical data were analyzed retrospectively. Receiver operating characteristic（ROC） curve and Logistic regression equation were used to analyze the roles of serum β-HCG ratio,progesterone and endometrial thickness determinations for predicting ectopic pregnancy. The predictive cut-off value of each index was determined,and the sensitivity and specificity of each index of single and combined determinations were evaluated. Results Serum β-HCG ratio,progesterone and endometrial thickness in ectopic pregnancy group were lower than those in normal pregnancy group（P〈0.001）. The single determinations of serum β-HCG ratio,progesterone and endometrial thickness were valuable for the prediction of ectopic pregnancy. When the cut-off value of progesterone was 55.3 nmol/L,the sensitivity was 90.4%,and the specificity was 78.6%. When the cut-off value of serum β-HCG ratio was 2.01,the sensitivity was 86.5%,and the specificity was 83.9%. When the cut-off value of endometrial thickness was 11.5 mm,the sensitivity was 86.5%,and the specificity was 60.7%. The sensitivity of the combined determination was 94.6%,and the specificity was 88.5%. The areas under the ROC curves of single and combined determinations were 0.852 for the determination of serum β-HCG ratio,0.845 for the determination of progesterone,0.736 for the determination of endometrial thickness,0.887 for the combined determination of progesterone and endometrial thickness,0.868 for the combined determination of serum β-HCG ratio and progesterone,0.867 for the combined determination of serum β-HCG ratio and endometrial thickness and 0.950 for the combined determination of 3 indices. Conclusions The combined determination of serum β-HCG ratio, progesterone and endometrial thickness for predicting ectopic pregnancy has good efficiency than that of any single determination for the early diagnosis of ectopic pregnancy.
作者
谢军
郑轩
马静
金勤
XIE Jun;ZHENG Xuan;MA Jing;JIN Qin(Department of Obstetrics and Gynecology,the International Peace Maternity and Child Health Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)
出处
《检验医学》
CAS
2018年第6期516-520,共5页
Laboratory Medicine
关键词
人绒毛膜促性腺激素
孕酮
子宫内膜厚度
异位妊娠
Human chorionic gonadotropin
Progesterone
Endometrial thickness
Ectopic pregnancy
