摘要
目的:探讨经阴道彩色多普勒超声联合血清雌二醇(E2)、人绒毛膜促性腺激素(β-HCG)早期预测妊娠结局价值。方法:收集早期妊娠女性240例,按妊娠结局将其分为正常妊娠组(n=95)、先兆流产组(n=68)和异位妊娠组(n=77)。采用阴道彩色多普勒超声测量子宫内膜厚度,并检测血清E2、β-HCG,比较各组子宫内膜厚度以及血清E2、β-HCG水平,探讨其联合诊断先兆流产、异位妊娠的价值。结果:正常妊娠组子宫内膜厚度明显大于先兆流产组、异位妊娠组(P<0.05),先兆流产组子宫内膜厚度明显大于异位妊娠组(P<0.05);正常妊娠组血清E2、β-HCG水平明显高于先兆流产组、异位妊娠组(P<0.05),先兆流产组血清E2、β-HCG水平明显高于异位妊娠组(P<0.05)。绘制ROC曲线,E2诊断先兆流产、异位妊娠的AUC为0.861、0.898,95%CI为0.799~0.923、0.841~0.954,β-HCG诊断AUC为0.950、0.927,95%CI为0.913~0.988、0.882~0.972,超声诊断AUC为0.878、0.882,95%CI为0.822~0.934、0.827~0.937,联合检测诊断AUC为0.983、0.978,95%CI为0.967~0.998、0.959~0.997,联合检测对先兆流产、异位妊娠诊断价值最高,超声联合血清E2、β-HCG检测对先兆流产、异位妊娠的诊断准确性、敏感度、特异度、阳性预测值、阴性预测值明显高于各指标单独检测。结论:阴道彩色多普勒超声联合血清E2、β-HCG检测可提高对早期先兆流产、异位妊娠的诊断价值,对早期预测妊娠结局有重要意义。
Objective:To explore the value of transvaginal color Doppler ultrasound combined with serum estradiol(E2)and human chorionic gonadotropin(β-HCG)in the early prediction of pregnancy outcomes.Methods:A retrospective study was performed on 240 early pregnancy women who were divided into normal pregnancy group(n=95),threatened abortion group(n=68)and ectopic pregnancy group(n=77)according to the pregnancy outcomes.The transvaginal color Doppler ultrasound was used to measure endometrial thickness,and serum E2 andβ-HCG were measured,and the endometrial thickness and levels of serum E2 andβ-HCG were compared among the groups,and the value of combination of the above indexes in diagnosing threatened abortion and ectopic pregnancy was analyzed.Results:The endometrial thickness in normal pregnancy group was significantly higher than that in threatened abortion group and ectopic pregnancy group(P<0.05),and the endometrial thickness in threatened abortion group was significantly higher than that in ectopic pregnancy group(P<0.05).The levels of serum E2 andβ-HCG in normal pregnancy group were significantly higher than those in threatened abortion group and ectopic pregnancy group(P<0.05),and the levels of serum E2 andβ-HCG in threatened abortion group were significantly higher than those in ectopic pregnancy group(P<0.05).ROC curves were drawn,and the AUC of E2 diagnosis of threatened abortion and ectopic pregnancy were 0.861 and 0.898,and 95%CI were 0.799~0.923 and 0.841~0.954,and the AUC ofβ-HCG diagnosis were 0.950 and 0.927,and 95%CI were 0.913~0.988 and 0.882~0.972,and the AUC of ultrasound diagnosis were 0.878 and 0.882,and 95%CI were 0.822~0.934 and 0.827~0.937,and the AUC of combined detection diagnosis were 0.983 and 0.978,and 95%CI were 0.967~0.998 and 0.959~0.997,and the combined detection had the highest diagnostic value on threatened abortion and ectopic pregnancy.The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of ultrasound combined withserum E2 andβ-HCG were significantly higher than those of each index in the detection of threatened abortion and ectopic pregnancy(P<0.05).Conclusion:Transvaginal color Doppler ultrasound combined with serum E2 andβ-HCG detection can improve the diagnostic value on early threatened abortion and ectopic pregnancy,and it is of great significance for early prediction of pregnancy outcomes.
作者
李柯狄
LI Kedi(Department of Ultrasound,Xindu District People’s Hospital,Chengdu,Chengdu 610500)
出处
《陕西医学杂志》
CAS
2020年第6期732-735,共4页
Shaanxi Medical Journal
基金
四川省卫生和计划生育委员会科研课题(2014JM02255)。
