超声RI和ET联合血β-hCG在宫外孕诊断中的价值研究

发布时间：2018-11-10 21:43

【摘要】：目的探讨超声联合血清人绒毛膜促性腺激素(β-h CG)检查在宫外孕中诊断价值。方法选择湖北省鄂州市中心医院2013年2月至2016年1月早期疑似异位妊娠的189例患者,按照术后及病理证实分为正常宫内妊娠组(A组)、宫内妊娠而自然流产组(B组)和异位妊娠组(C组),分析不同组别子宫内膜血流参数值及β-h CG的变化,子宫内膜参数值包括收缩期最大血流流速(VS)、舒张末期流速(VD)及阻力指数(RI)。建立ROC曲线分析各超声指标联合β-h CG在宫外孕中的诊断效能。结果 A组β-h CG、双层子宫内膜厚度(ET)均显著高于B、C组(t值分别为6.24、4.39、4.66、5.75,均P0.05),而VS、VD及RI均显著低于B、C组(t值分别为4.36、5.54、5.61、4.71、7.72、6.73,均P0.05),C组VS、RI、附件区包块大小与B组比较有显著性差异(t值分别为5.17、4.61、8.28,均P0.05)。RI、ET及β-h CG三者联合诊断时,其敏感度、特异性、阳性预测值、阴性预测值分别为93.83%、98.38%、99.81%、95.16%,其曲线下面积(AUC)为0.918,优于RI+β-h CG、ET+β-h CG诊断价值(Z=5.541,P=0.025)。结论超声诊断子宫内膜厚度、阻力指数联合β-h CG有助于提高早期宫外孕的诊断价值。
[Abstract]:Objective to investigate the diagnostic value of ultrasound combined with serum human chorionic gonadotropin (尾-h CG) in ectopic pregnancy. Methods 189 patients with suspected ectopic pregnancy from February 2013 to January 2016 in Ezhou Central Hospital of Hubei Province were selected and divided into normal intrauterine pregnancy group (group A) according to postoperative and pathological results. The changes of endometrial blood flow parameters and 尾-h CG in different groups of ectopic pregnancy and spontaneous abortion group (group B) and ectopic pregnancy group (group C) were analyzed. The endometrial parameters included maximum systolic blood flow velocity (VS),). End diastolic velocity (VD) and resistance index (RI). ROC curve was established to analyze the diagnostic efficacy of ultrasound combined with 尾-h CG in ectopic pregnancy. Results (ET) of 尾 -h CG, double layer endometrium in group A was significantly higher than that in group C (t = 6.244.39 卤4.66, P 0.05), while VS,VD and RI were significantly lower than those in group B, respectively. Group C (t = 4.36 卤5.54n 5.61n 4.71U 7.72n 6.73, respectively). There was significant difference in the size of VS,RI, adnexal mass between), C group and B group (t = 5.17 卤4.61, P < 0.05). RI,). The sensitivity, specificity, positive predictive value and negative predictive value of ET and 尾 -h CG were 93.833 and 98.38, respectively. The area under the curve was 0.918, and the area under the curve was 0.918. The diagnostic value of RI 尾 -h CG,ET 尾 -h CG was better than that of RI 尾 -h CG,ET 尾 -h CG. Conclusion Ultrasonic diagnosis of endometrial thickness and resistance index combined with 尾-h CG is helpful to improve the diagnostic value of early ectopic pregnancy.
【作者单位】：湖北省鄂州市中心医院超声科;
【分类号】：R714.22

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