动态监测子宫螺旋动脉血流参数、血清CA125、β-h CG、孕酮在预测早期先兆流产妊娠结局中的临床价值

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英文篇名：Clinical value of dynamic monitoring of uterine spiral artery blood flow parameters,serum CA125,β-h CG,and progesterone in predicting pregnancy outcome of early threatened abortion 作者：于亚莉 英文作者：YU Ya-Li;Department of Gynecology and Obstetrics,Nanchong Central Hospital; 关键词：USA血流参数 ; CA125 ; β-h ; CG ; 孕酮 ; 早期先兆流产 ; 妊娠结局 英文关键词：USA blood flow parameter;;CA125;;β-h CG;;Progesterone;;Early threatened abortion;;Pregnancy outcome 中文刊名：ZFYB 英文刊名：Maternal and Child Health Care of China 机构：南充市中心医院妇产科; 出版日期：2019-03-15 出版单位：中国妇幼保健 年：2019 期：v.34 语种：中文; 页：ZFYB201906041 页数：4 CN：06 ISSN：22-1127/R 分类号：127-130

摘要

目的动态监测早期先兆流产孕妇子宫螺旋动脉(USA)血流参数、血清CA125、β-h CG及孕酮(P)的变化,探讨其在早期先兆流产妊娠结局预测中的临床价值。方法选取2015年1月-2017年6月在南充市中心医院妇产科就诊的早期先兆流产孕妇230例为研究对象,根据妊娠结局分为妊娠持续组151例和妊娠失败组79例,另选取同期在该院孕检的正常孕妇100例为对照组。分别于治疗前、治疗第1周、4周采用电化学发光免疫法检测CA125、β-h CG及P水平,采用彩色多普勒超声诊断仪检测USA血流参数。对比3组孕妇USA血流参数、血清CA125、β-h CG、P水平的差异,并分别计算USA血流参数、血清CA125、β-h CG、P单独及联合预测早期先兆流产的灵敏度、特异度、阳性预测值及阴性预测值。结果治疗前后妊娠失败组USA血流参数、血清CA125均高于妊娠持续组和对照组,β-h CG、P水平均低于妊娠持续组和对照组,差异有统计学意义(P<0. 05)。治疗前、治疗1周后妊娠持续组USA血流参数、血清CA125均高于对照组,β-h CG、P水平均低于对照组,差异有统计学意义(P<0. 05);治疗4周后,妊娠持续组USA血流参数、血清CA125、β-h CG、P水平与对照组接近,差异无统计学意义(P>0. 05)。USA血流参数、血清CA125、β-h CG、P水平联合检测的阳性预测值、阴性预测值、灵敏度、特异度、准确度均高于单独检测,差异有统计学意义(P<0. 05)。结论动态监测USA血流参数、血清CA125、β-h CG、P水平可提高早期先兆流产的检出率,并在一定程度上反映妊娠结局,检验能效较高,值得在临床上推广使用。
        Objective To dynamically monitor the changes of uterine spiral artery( USA) blood flow parameters,serum CA125,β-human chorionic gonadotropin( β-h CG),and progesterone( P) in pregnant women of early threatened abortion,explore the clinical value in predicting pregnancy outcome of early threatened abortion. Methods A total of 230 pregnant women of early threatened abortion were selected from Department of Gynecology and Obstetrics,Nanchong Central Hospital from January 2015 to June 2017 as study object,then they were divided into continuous pregnancy group( 151 cases) and failed pregnancy group( 79 cases) according to pregnancy outcome. A total of 100 normal pregnant women receiving prenatal examination in the hospital during the same period were selected as control group. Electrochemiluminescence immunoassay was used to detect the levels of CA125,β-h CG,and P before treatment,at 1 and 4 weeks after treatment.Color Doppler ultrasound was used to detect USA blood flow parameters. USA blood flow parameters,serum CA125,β-h CG,P levels in the three groups were compared. The sensitivities,specificities,positive predictive values,and negative predictive values of single detection and conbined detection of USA blood flow parameters,serum CA125,β-h CG,P in predicting early threatened abortion were calculated,respectively. Results Before and after treatment,USA blood flow parameters and serum CA125 levels in failed pregnancy group were statistically significantly higher than those in continuous pregnancy group and control group,the levels of β-h CG and P in failed pregnancy group were statistically significantly lower than those in continuous pregnancy group and control group( P<0. 05). Before treatment and at one week after treatment,USA blood flow parameters and serum CA125 levels in continuous pregnancy group were statistically significantly higher than those in control group,the levels of β-h CG and P in continuous pregnancy group were statistically significantly lower than those in control group( P<0. 05). At four weeks after treatment,there was no statistically significant difference in USA blood flow parameters,serum CA125,β-h CG,and P levels between continuous pregnancy group and control group( P>0. 05). The positive predictive value,negative predictive value,sensitivity,specificity,and accuracy of conbined detection of USA blood flow parameters,serum CA125,β-h CG,P levels in predicting early threatened abortion were statistically significantly higher than those of single detection( P<0. 05). Conclusion Dynamic monitoring of USA blood flow parameters,serum CA125,β-h CG,P levels can increase detection rate of early threatened abortion and reflect pregnancy outcome to a certain degree,which is effective and worthy of clinical promotion and application.

引文

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