【摘要】：目的探討超聲聯(lián)合血清人絨毛膜促性腺激素(β-h CG)檢查在宮外孕中診斷價(jià)值。方法選擇湖北省鄂州市中心醫(yī)院2013年2月至2016年1月早期疑似異位妊娠的189例患者,按照術(shù)后及病理證實(shí)分為正常宮內(nèi)妊娠組(A組)、宮內(nèi)妊娠而自然流產(chǎn)組(B組)和異位妊娠組(C組),分析不同組別子宮內(nèi)膜血流參數(shù)值及β-h CG的變化,子宮內(nèi)膜參數(shù)值包括收縮期最大血流流速(VS)、舒張末期流速(VD)及阻力指數(shù)(RI)。建立ROC曲線分析各超聲指標(biāo)聯(lián)合β-h CG在宮外孕中的診斷效能。結(jié)果 A組β-h CG、雙層子宮內(nèi)膜厚度(ET)均顯著高于B、C組(t值分別為6.24、4.39、4.66、5.75,均P0.05),而VS、VD及RI均顯著低于B、C組(t值分別為4.36、5.54、5.61、4.71、7.72、6.73,均P0.05),C組VS、RI、附件區(qū)包塊大小與B組比較有顯著性差異(t值分別為5.17、4.61、8.28,均P0.05)。RI、ET及β-h CG三者聯(lián)合診斷時(shí),其敏感度、特異性、陽性預(yù)測值、陰性預(yù)測值分別為93.83%、98.38%、99.81%、95.16%,其曲線下面積(AUC)為0.918,優(yōu)于RI+β-h CG、ET+β-h CG診斷價(jià)值(Z=5.541,P=0.025)。結(jié)論超聲診斷子宮內(nèi)膜厚度、阻力指數(shù)聯(lián)合β-h CG有助于提高早期宮外孕的診斷價(jià)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 鹵4.66, P 0.05), while VS,VD and RI were significantly lower than those in group B, respectively. Group C (t = 4.36 鹵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 鹵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.
【作者單位】： 湖北省鄂州市中心醫(yī)院超聲科;
【分類號】：R714.22

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