联合检测β-hCG、P及ET对早期异位妊娠患者的诊断价值
|
摘要
目的分析血清人绒毛膜性腺激素(β-hCG)、孕酮(P)及子宫内膜厚度(ET)联合检测在不明位置妊娠(PUL)早期异位妊娠(EP)患者中的诊断价值。方法回顾性分析2018年1至12月在永康市中医院就诊的68例早期EP患者(观察组)和72例正常宫内妊娠者(对照组)的临床资料。比较两组患者的血清β-hCG、P水平及ET,受试者工作特征曲线(ROC)分析血清β-hCG、P及ET在早期EP患者中的诊断价值。结果观察组患者的血清β-hCG及P水平、ET显著低于对照组(t值分别为38.734、16.995、7.967,均P<0.05)。ROC曲线结果显示血清β-hCG对EP的预测价值最高(73.5%),P预测价值最低(66.2%)。血清β-hCG为4 890.4mIU/mL、P为30.19nmol/L、ET为16mm可分别作为预测诊断EP的临界值。不同指标联合时对EP的ROC曲线分析结果显示三项联合预测价值最高(97.1%)。结论血清β-hCG、P及ET联合检测在PUL早期EP患者中具有突出的诊断价值。
Objective To analyze the diagnostic value of combined detection of serum β-human chorionic gonadotropin(β-hCG),(progesterone) P and endometrial thickness(ET) in pregnancy of unknown location(PUL) with ectopic pregnancy(EP). Methods Retrospective analysis was conducted on the clinical data of 68 cases of early EP(observation group) and 72 normal pregnancy women(control group) receiving treatment in Traditional Chinese Medicine of Yongkang Hospital from January to December 2018. The levels of β-hCG, P and ET in two groups were compared, and the diagnostic value of β-hCG, P and ET in early EP cases was analyzed by receiver operating characteristic curve(ROC). Results Serum levels of β-hCG and P as well as ET in the observation group were significantly lower than those in the control group(t value was 38.734, 16.995 and 7.967, respectively, all P<0.05). ROC curve results showed that serum β-hCG had the highest predictive value for EP(73.5%) and P level had the lowest predictive value(66.2%). Serum β-hCG of 4 890.4 mIU/mL, P of 30.19 nmol/L, ET of 16 mm could be used as the critical values for the prediction of EP, and the predictive value of combining three indicators was highest(97.1%). Conclusion The combined detection of serum β-hCG, P and ET in early EP patients with PUL has significant diagnostic value.
Objective To analyze the diagnostic value of combined detection of serum β-human chorionic gonadotropin(β-hCG),(progesterone) P and endometrial thickness(ET) in pregnancy of unknown location(PUL) with ectopic pregnancy(EP). Methods Retrospective analysis was conducted on the clinical data of 68 cases of early EP(observation group) and 72 normal pregnancy women(control group) receiving treatment in Traditional Chinese Medicine of Yongkang Hospital from January to December 2018. The levels of β-hCG, P and ET in two groups were compared, and the diagnostic value of β-hCG, P and ET in early EP cases was analyzed by receiver operating characteristic curve(ROC). Results Serum levels of β-hCG and P as well as ET in the observation group were significantly lower than those in the control group(t value was 38.734, 16.995 and 7.967, respectively, all P<0.05). ROC curve results showed that serum β-hCG had the highest predictive value for EP(73.5%) and P level had the lowest predictive value(66.2%). Serum β-hCG of 4 890.4 mIU/mL, P of 30.19 nmol/L, ET of 16 mm could be used as the critical values for the prediction of EP, and the predictive value of combining three indicators was highest(97.1%). Conclusion The combined detection of serum β-hCG, P and ET in early EP patients with PUL has significant diagnostic value.
引文
[1]De Nola R,Sch?nauer L M,Fiore M G,et al.Management of placental site trophoblastic tumor:two case reports[J].Medicine (Baltimore),2018,97(48):e13439.
[2]Tandulwadkar S R,Naralkar M V,Surana A D,et al.Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles:apilot study[J].J Hum Reprod Sci,2017,10(3):208-212.
[3]Mumtaz A,Khalid A,Jamil Z,et al.Kisspeptin:A potential factor for unexplained infertility and impaired embryo implantation[J].Int J Fertil Steril,2017,11(2):99-104.
[4]Yadav P,Singla A,Sidana A,et al.Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy[J].Int J Gynaecol Obstet,2017,136(1):70-75.
[5]Yuan X,Saravelos S H,Wang Q,et al.Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF-ICSI cycles[J].Reprod Biomed Online,2016,33(2):197-205.
[6]Santamaria X,Cabanillas S,Cervelló I,et al.Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy:a pilot cohort study[J].Hum Reprod,2016,31(5):1087-96.
[7]Gong F,Li X,Zhang S,et al.A modified ultra-long pituitary downregulation protocol improved endometrial receptivity and clinical outcome for infertile patients with polycystic ovarian syndrome[J].Exp Ther Med,2015,10(5):1865-1870.
[8]Y?ld?r?m A,C?r?k D A,Altay M,et al.Early prediction for the requirement of second or third dose methotrexate in women with ectopic pregnancy,treated with single-dose regimen[J].Arch Gynecol Obstet,2015,291(6):1327-32.
[9]赵富清,刘清秀,罗利平.血清β-hCG、子宫内膜厚度与不明位置妊娠患者妊娠结局的相关性研究[J].中国妇幼健康研究,2015,26(6):1251-1253.1258.
[2]Tandulwadkar S R,Naralkar M V,Surana A D,et al.Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles:apilot study[J].J Hum Reprod Sci,2017,10(3):208-212.
[3]Mumtaz A,Khalid A,Jamil Z,et al.Kisspeptin:A potential factor for unexplained infertility and impaired embryo implantation[J].Int J Fertil Steril,2017,11(2):99-104.
[4]Yadav P,Singla A,Sidana A,et al.Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy[J].Int J Gynaecol Obstet,2017,136(1):70-75.
[5]Yuan X,Saravelos S H,Wang Q,et al.Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF-ICSI cycles[J].Reprod Biomed Online,2016,33(2):197-205.
[6]Santamaria X,Cabanillas S,Cervelló I,et al.Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy:a pilot cohort study[J].Hum Reprod,2016,31(5):1087-96.
[7]Gong F,Li X,Zhang S,et al.A modified ultra-long pituitary downregulation protocol improved endometrial receptivity and clinical outcome for infertile patients with polycystic ovarian syndrome[J].Exp Ther Med,2015,10(5):1865-1870.
[8]Y?ld?r?m A,C?r?k D A,Altay M,et al.Early prediction for the requirement of second or third dose methotrexate in women with ectopic pregnancy,treated with single-dose regimen[J].Arch Gynecol Obstet,2015,291(6):1327-32.
[9]赵富清,刘清秀,罗利平.血清β-hCG、子宫内膜厚度与不明位置妊娠患者妊娠结局的相关性研究[J].中国妇幼健康研究,2015,26(6):1251-1253.1258.