發(fā)布時間：2018-03-16 04:20

  本文選題：流產(chǎn)　切入點：自然　出處：《中國全科醫(yī)學(xué)》2017年13期 　論文類型：期刊論文

【摘要】：目的探討妊娠第7周超聲檢查指標和血清孕酮水平對自發(fā)性流產(chǎn)的預(yù)測價值。方法選取2013年1月—2015年12月在麗水市婦幼保健院建檔的孕婦220例,胎齡均為7周。均行經(jīng)陰道超聲檢查,以收集第7周的胎兒心率(FHR)、平均孕囊直徑(MGSD)、頂臀長(CRL),并計算平均孕囊直徑-頂臀長比值(MGSD/CRL);同時行血清孕酮水平檢測。根據(jù)后期妊娠結(jié)局,將納入孕婦分為自發(fā)性流產(chǎn)組(n=34)和非自發(fā)性流產(chǎn)組(n=186)。比較兩組超聲檢查指標和血清孕酮水平,并分析其對自發(fā)性流產(chǎn)的預(yù)測價值。結(jié)果兩組年齡、胎齡、CRL、血清孕酮水平比較,差異無統(tǒng)計學(xué)意義(P0.05);自發(fā)性流產(chǎn)組FHR、MGSD、MGSD/CRL低于非自發(fā)性流產(chǎn)組,差異有統(tǒng)計學(xué)意義(P0.05)。多因素Logistic回歸分析結(jié)果顯示,FHR、MGSD、MGSD/CRL是孕婦發(fā)生自發(fā)性流產(chǎn)的影響因素(P0.05)。受試者工作特征(ROC)曲線結(jié)果顯示,FHR、MGSD、MGSD/CRL預(yù)測自發(fā)性流產(chǎn)的臨界值分別為111.15次/min、16.00 mm、11.27,靈敏度分別為98.4%、78.0%、93.0%,特異度分別為88.2%、100.0%、91.2%,ROC曲線下面積(AUC)分別為0.863、0.745、0.848;三者聯(lián)合應(yīng)用預(yù)測自發(fā)性流產(chǎn)的靈敏度為89.2%,特異度為91.2%,AUC為0.948。結(jié)論妊娠第7周FHR、MGSD、MGSD/CRL及三者聯(lián)合應(yīng)用對自發(fā)性流產(chǎn)均有較好的預(yù)測價值。
[Abstract]:Objective to study the predictive value of ultrasound examination and serum progesterone level in spontaneous abortion in the 7th week of pregnancy. Methods 220 pregnant women who were in the Lishui Maternal and Child Health Hospital from January 2013 to December 2015 were selected. The gestational age was 7 weeks. All fetuses were examined by transvaginal ultrasound to collect fetal heart rate and FHRs, mean gestational sac diameter (MGSD), parietal and gluteal length (CRL), and to calculate the mean gestational sac diameter-hip length ratio (MGSD-CRLL). Serum progesterone levels were also measured according to the outcome of late pregnancy. Pregnant women were divided into spontaneous abortion group and non-spontaneous abortion group. The ultrasonic examination index and serum progesterone level were compared between the two groups, and their predictive value for spontaneous abortion was analyzed. Results the age, gestational age and serum progesterone levels were compared between the two groups. There was no significant difference between the two groups (P 0.05), and the FHR-MGSD-MGSD-CRL in spontaneous abortion group was lower than that in non-spontaneous abortion group. The results of multivariate Logistic regression analysis showed that MGSD / CRL was the influential factor of spontaneous abortion in pregnant women (P 0.05). The result of ROC curve showed that the critical value of predicting spontaneous abortion was 111.15 times / min / L, respectively. The sensitivity was 98.4% and 78.0% and 93.0, respectively, and the specificity was 88.20.100.0and the area under the ROC curve was 0.8630.7450.848, respectively. The sensitivity and specificity of the combined application for predicting spontaneous abortion were 89.2and 91.2AUC were 0.948 respectively. Conclusion in the 7th week of gestation, FHRM MGSDMGSD-CRL and their combined application in spontaneous spontaneous abortion are effective in the diagnosis of spontaneous spontaneous abortion. [WT5HZ] [WT5 "BZ] [WT5" HZ] [WT5 "BZ] [WT5BZ] the sensitivity of the combined use of the three methods in predicting spontaneous abortion is 89.2 and the specificity is 0.948. Abortion has good predictive value.
【作者單位】： 浙江省麗水市婦幼保健院超聲科;浙江省麗水市婦幼保健院檢驗科;上海市第十人民醫(yī)院超聲科;
【基金】：上海市衛(wèi)生局科研課題(20134023)
【分類號】：R445.1;R714.21

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