摘要
目的探究经阴道超声自由解剖成像技术联合血清β-人绒毛膜促性腺激素(β-HCG)、血管内皮生长因子(VEGF)检测对早期输卵管妊娠的诊断价值。方法选取怀疑为早期输卵管妊娠的患者67例,另选取同期193例正常宫内妊娠患者作为正常对照。所有患者均接受经阴道超声自由解剖成像检查及血清β-HCG、VEGF检测。观察超声诊断图像,分析经阴道超声自由解剖成像诊断结果与临床确诊的一致性。通过确定血清β-HCG、VEGF诊断的切断值(Cut-off),分析经阴道超声自由解剖成像、血清β-HCG、VEGF单独诊断及三者联合诊断早期输卵管妊娠的灵敏度、特异度及诊断准确率,以评价联合诊断的临床价值。结果67例患者中输卵管妊娠48例(71.6%),其中输卵管壶腹部妊娠31例,峡部妊娠15例,间质部妊娠2例;各型输卵管妊娠超声图像各有特点。与正常宫内妊娠患者相比,输卵管妊娠患者血清β-HCG含量明显降低,VEGF含量明显升高(P<0.05)。血清β-HCG诊断的Cut-off值为4025.03 IU/L,VEGF诊断的Cut-off值为345.89 ng/L。经阴道超声自由解剖成像诊断输卵管妊娠与临床确诊结果具有较好的一致性(Kappa=0.862,P=0.000)。经阴道超声自由解剖成像联合血清β-HCG、VEGF诊断输卵管妊娠的准确度为97.0%、灵敏度为97.9%、特异度为94.7%,具有较高的临床诊断价值。结论经阴道超声自由解剖成像联合血清β-HCG、VEGF诊断输卵管妊娠具有较高的诊断灵敏度、特异度及准确率,可在临床中推广应用。
Aim To explore the diagnostic value of transvaginal ultrasound free anatomical imaging combined with serumβ-human chorionic gonadotropin(β-HCG)and vascular endothelial growth factor(VEGF)in early tubal pregnancy.Methods Sixty-seven patients suspected of early tubal pregnancy were prospectively selected,and 193 patients with normal intrauterine pregnancy during the same period were selected as controls.All patients underwent transvaginal ultrasound free anatomical imaging and serumβ-HCG and VEGF detection to analyze the consistency between the results of free anatomical transvaginal ultrasound and the clinical diagnosis.By determining the cut-off value of serumβ-HCG and VEGF diagnosis,the sensitivity,specificity and diagnostic accuracy of free anatomical transvaginal ultrasound imaging,serumβ-HCG and VEGF alone diagnosis and the combination of the three in the diagnosis of early tubal pregnancy were analyzed,so as to evaluate the clinical value of combined diagnosis.Results Of the 67 patients,48 cases(71.6%)were tubal pregnancy,including 31 cases of ampullary tubal pregnancy,15 cases of isthmus pregnancy and 2 cases of interstitial pregnancy.Ultrasound images of each type of tubal pregnancy have their own characteristics.Compared with normal intrauterine pregnancy patients,the serumβ-HCG content was significantly decreased and the serum VEGF content was significantly increased in tubal pregnancy patients(P<0.05).The cut-off value of serumβ-HCG diagnosis was 4025.03 IU/L,and the cut-off value of VEGF diagnosis was 345.89 ng/L.The diagnosis of tubal pregnancy by transvaginal ultrasound free anatomical imaging was consistent with the clinical diagnosis(Kappa=0.862,P=0.000).The accuracy,sensitivity and specificity of transvaginal free anatomical ultrasound combined with serumβ-HCG and VEGF in the diagnosis of tubal pregnancy were 97.0%,97.9%and 94.7%,indicating that the clinical diagnostic efficacy better than any single diagnostic item and had high clinical diagnostic value.Conclusion Transvaginal ultrasound free anatomical imaging combined with serumβ-HCG and VEGF in the diagnosis of tubal pregnancy has high diagnostic sensitivity,specificity and accuracy,and can be popularized in clinical application.
作者
徐新华
胡庆兰
邵铃
XU Xinhua;HU Qinglan;SHAO Ling(Department of Ultrasound Section,Anhui Wannan Rehabilitation Hospital&the Fifth Peopled Hospital of Wuhu,Wuhuy Anhui 241000,China;Department of Obstetrics and Gynecology,Anhui Wannan Rehabilitation Hospital&the Fifth Peopled Hospital of Wuhu,Wuhuy Anhui 241000,China)
出处
《中南医学科学杂志》
CAS
2021年第4期423-426,463,共5页
Medical Science Journal of Central South China
基金
安徽省重点研发和开发计划项目(1804h08020120)。
作者简介
徐新华,主治医师,研究方向为宫外孕的超声诊断,E-mail为gn44r3@163.com。
