经腹部彩超联合血清β-HCG及ALP水平检测在宫外孕早期诊断中的应用价值
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摘要
目的:探究血清β-人绒毛膜促性腺激素(β-HCG)及碱性磷酸酶(ALP)水平检测联合经腹部彩超在宫外孕早期诊断中的应用价值。方法:选取2017年3月至2018年3月在我院产科诊治的宫外孕患者47例为宫外孕组,同期选取正常妊娠孕妇51例作为正常妊娠组,回顾性分析各研究对象血清中β-HCG、ALP水平和经腹部彩超测得的子宫内是否有孕囊、内膜厚度等指标并进行比较。结果:宫外孕组腹痛、阴道出血、腹部压痛、子宫增大、附件区压痛、宫颈举痛等发生率显著高于正常妊娠组(P<0.05)。宫外孕组患者血清β-HCG水平显著低于正常妊娠组[(1554.12±279.21) vs (3267.98±610.21)mIU/mL,P <0.05];血清ALP水平明显低于正常妊娠组[(29.45±5.23) vs (42.37±9.72) mIU/mL,P <0.05]。Spearman检验结果显示,宫外孕组患者血清β-HCG与ALP水平呈明显正相关(r=0.630,P <0.05)。宫外孕组子宫内膜厚度≤10mm、附件区有包块、宫内无孕囊、无胎心搏动等发生率明显高于正常妊娠组(P<0.05)。血清β-HCG、ALP检测联合经腹部彩超检测诊断宫外孕特异性较高,为96.08%。结论:血清β-HCG、ALP指标联合经腹部彩超检测可明显提高宫外孕早期诊断的特异性,具有一定临床推广意义。
Objective:To investigate the value of serum β-human chorionic gonadotropin(β-HCG),alkaline phosphatase(ALP) and transabdominal color doppler ultrasound in the diagnosis of ectopic pregnancy.Methods:A total of 47 patients with ectopic pregnancy in our hospital from March 2017 to March 2018 were selected.51 pregnant women with normal pregnancy were selected as controls.Retrospective analysis of serum β-HCG,ALP level and the gestational sac,endometrial thickness and other indicators detected by transabdominal color Doppler ultrasound and compared.Results:The incidence of abdominal pain,vaginal bleeding,abdominal tenderness,uterine enlargement,attachment tenderness and cervical lift were significantly higher in ectopic pregnancy group than that in normal pregnancy group(P <0.05).The level of serum β-HCG in ectopic pregnancy group was significantly lower than that in normal pregnancy group [(1554.12±279.21) vs(3267.98±610.21) m IU/mL,P <0.05].The level of serum ALP in ectopic pregnancy group was significantly lower than those in the normal pregnancy group [(29.45±5.23) vs(42.37±9.72) m IU/mL,P <0.05].Spearman test showed that serum β-HCG level was positively correlated with ALP level in ectopic pregnancy group(r = 0.630,P <0.05).The incidence of endometrial thickness ≤ 10 mm,attachment area with mass,intrauterine no gestational sac,fetal heart rate in ectopic pregnancy group was significantly higher than that of the normal pregnancy group(P <0.05).The of serum β-HCG and ALP in combination with abdominal color Doppler ultrasonography were 96.08%,which were higher than those used one of them(P <0.05).Conclusion:Combined serum β-HCG,ALP with abdominal color Doppler ultrasonography can significantly improve the diagnosis rate of early ectopic pregnancy,which is valuable to promote.
Objective:To investigate the value of serum β-human chorionic gonadotropin(β-HCG),alkaline phosphatase(ALP) and transabdominal color doppler ultrasound in the diagnosis of ectopic pregnancy.Methods:A total of 47 patients with ectopic pregnancy in our hospital from March 2017 to March 2018 were selected.51 pregnant women with normal pregnancy were selected as controls.Retrospective analysis of serum β-HCG,ALP level and the gestational sac,endometrial thickness and other indicators detected by transabdominal color Doppler ultrasound and compared.Results:The incidence of abdominal pain,vaginal bleeding,abdominal tenderness,uterine enlargement,attachment tenderness and cervical lift were significantly higher in ectopic pregnancy group than that in normal pregnancy group(P <0.05).The level of serum β-HCG in ectopic pregnancy group was significantly lower than that in normal pregnancy group [(1554.12±279.21) vs(3267.98±610.21) m IU/mL,P <0.05].The level of serum ALP in ectopic pregnancy group was significantly lower than those in the normal pregnancy group [(29.45±5.23) vs(42.37±9.72) m IU/mL,P <0.05].Spearman test showed that serum β-HCG level was positively correlated with ALP level in ectopic pregnancy group(r = 0.630,P <0.05).The incidence of endometrial thickness ≤ 10 mm,attachment area with mass,intrauterine no gestational sac,fetal heart rate in ectopic pregnancy group was significantly higher than that of the normal pregnancy group(P <0.05).The of serum β-HCG and ALP in combination with abdominal color Doppler ultrasonography were 96.08%,which were higher than those used one of them(P <0.05).Conclusion:Combined serum β-HCG,ALP with abdominal color Doppler ultrasonography can significantly improve the diagnosis rate of early ectopic pregnancy,which is valuable to promote.
引文
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[9]Dhombres F,Maurice P,Friszer S,et al.Developing a knowledge base to support the annotation of ultrasound images of ectopic pregnancy[J].Journal of Biomedical Semantics,2017,8(1):4~10.
[2]龚惠,陆文怡,赵爱民.血清孕酮及人绒毛膜促性腺激素早期预测异位妊娠的价值[J].广东医学,2014,35(14):2231~2234.
[3]Hsu J Y,Chen L,Gumer A R,et al.Disparities in the management of ectopic pregnancy[J].American Journal of Obstetrics&Gynecology,2017,217(1):e1~e10.
[4]Mavrelos D,Memtsa M,Helmy S,et al.β-h CG resolution times during expectant management of tubal ectopic pregnancies[J].Bmc Womens Health,2015,15(1):1~5.
[5]李红霞.血清β-h CG与CRP水平在预测胎膜早破宫内感染及预后的应用比较[J].中华医院感染学杂志,2012,22(10):2106~2108.
[6]卢慧,陈红晓.血清β-HCG、P、VEGF、INH-A单独及联合检测在异位妊娠早期诊断中的作用[J].山东医药,2015,19(1):81~83.
[7]欧志强.碱性磷酸酶(ALP)在妊娠晚期的监测和变化分析[J].医学检验与临床,2017,28(8):43~44.
[8]吴春华.血清孕酮、β-HCG及ALP水平在宫外孕诊断中的临床价值分析[J].医学检验与临床,2016,27(8):30~32.
[9]Dhombres F,Maurice P,Friszer S,et al.Developing a knowledge base to support the annotation of ultrasound images of ectopic pregnancy[J].Journal of Biomedical Semantics,2017,8(1):4~10.