血清β-HCG阴道超声阈值联合子宫内膜厚度诊断异位妊娠的价值

发布时间：2018-03-30 09:21

本文选题：异位妊娠　切入点：β-HCG　出处：《临床和实验医学杂志》2017年01期

【摘要】：目的探讨血清β人绒毛膜促性腺激素(β-HCG)阴道超声阈值联合子宫内膜厚度诊断异位妊娠时的诊断效能。方法选择198例疑似异位妊娠患者,其中确诊异位妊娠的患者108例为研究组,正常宫内妊娠者90例作为对照组。观察并比较两组血清β-HCG水平和子宫内膜厚度,计算在获得最佳诊断效能时的血清β-HCG阴道超声阈值和子宫内膜厚度。结果当血清β-HCG水平为1 125 IU/L,子宫内膜厚度为8.02 mm时,其约登指数最大。单独采用血清β-HCG水平诊断时的约登指数为0.744,ROC曲线下面积为0.845。单独采用子宫内膜厚度诊断的约登指数为0.615,ROC曲线下面积为0.769。当两者联合检测时能获得更高的诊断效能,其敏感度为88.88%,特异度为90.00%,阳性预测值为91.43%,阴性预测值为87.10%,约登指数为0.788,ROC曲线下面积为0.895。结论对于临床症状不典型的疑似异位妊娠的患者,进行血清β-HCG和子宫内膜厚度联合检测可提高早期异位妊娠的诊断效能。
[Abstract]:Objective to investigate the diagnostic efficacy of serum 尾 -human chorionic gonadotropin (尾 -HCG) in the diagnosis of ectopic pregnancy. Methods 198 patients with suspected ectopic pregnancy were selected. 90 cases of normal intrauterine pregnancy were used as control group. Serum 尾 -HCG level and endometrial thickness were observed and compared between the two groups. The threshold value and endometrial thickness of serum 尾 -HCG were calculated when the best diagnostic efficacy was obtained. Results when the serum 尾 -HCG level was 1 125 IUU / L and the endometrial thickness was 8.02 mm, When using serum 尾 -HCG alone, the area under the ROC curve was 0.845, and the area under the ROC curve using endometrial thickness alone was 0.615. The area under the ROC curve was 0.769.When the two tests were combined, the Yorden index was 0.845. With a higher diagnostic efficiency, The sensitivity, specificity, positive predictive value, negative predictive value and area under the ROC curve were 88.88, 90.00,91.43, 87.1010 and 0.895.Conclusion for suspected ectopic pregnancy patients with atypical clinical symptoms, the sensitivity is 88.88, the positive predictive value is 91.43, the negative predictive value is 87.1010, and the area under the ROC curve is 0.788. Combined detection of serum 尾-HCG and endometrial thickness can improve the diagnostic efficacy of early ectopic pregnancy.
【作者单位】：上海市同仁医院上海交通大学医学院附属同仁医院妇产科;
【分类号】：R714.22

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