摘要
目的:探讨血清基质金属蛋白酶(MMP)9和髓细胞白血病蛋白1(MCL1)联合超声对异位妊娠(EP)的早期诊断价值。方法:收集本院2023年7月-2024年7月收治的EP患者88例为EP组,正常宫内妊娠孕妇94例为对照组。检测血清MMP9、MCL1和β-人绒毛膜促性腺激素(β-hCG),经阴道超声检测子宫内膜厚度、阻力指数(RI)和搏动指数(PI);多因素logistic回归分析EP发生的影响因素;采用受试者工作特征曲线(ROC)分析血清MMP9、MCL1诊断EP的价值,血清MMP9、MCL1联合超声诊断效能采用四格表计算。结果:EP组β-hCG和MCL1(9.08±2.10 ng/ml)水平低于对照组(13.62±3.03 ng/ml),MMP9水平(406.25±64.18μg/L)高于对照组(334.56±51.39μg/L)(均P<0.05)。超声诊断EP的敏感度为87.5%、特异度90.4%,Kappa检验显示与病理诊断一致性较高(Kappa值=0.780,P<0.001)。相较对照组,EP组子宫内膜厚度较薄,RI和PI较高(均P<0.05)。多因素logistic回归分析显示,β-hCG升高、MCL1升高和子宫内膜厚度增加为EP的保护因素,MMP9升高、RI升高和PI升高为EP的危险因素(均P<0.05)。血清MMP9联合MCL1诊断EP的敏感度78.4%、特异度88.3%;血清MMP9、MCL1联合超声诊断EP的敏感度95.5%、特异度87.2%。结论:EP患者血清MMP9水平较高、MCL1水平较低,血清MMP9、MCL1联合超声诊断EP的敏感度最高。
Objective:To explore the value of the levels of the serum matrix metalloproteinase(MMP)9 and myeloid cell leukemia 1(MCL1)combined with the ultrasound for early diagnosing the ectopic pregnancy(EP).Methods:From July 2023 to July 2024,88 women with EP who admitted to the hospital were regarded as study group,and 94 women with normal intrauterine pregnancy were selected in control group.The levels of the serum MMP9,MCL1 andp-human chorionic gonadotropin(β-hCG)of the women in the two groups were measured.Transvaginal ultrasound was used to detect the endometrial thickness and the values of resistance index(RI)and pulsatility index(PI)of the women in the two groups.Multivariate logistic regression was used to analyze the influencing factors of the EP occurrence of the women.Receiver operator characteristic(ROC)curve was used to analyze the diagnostic value of the serum MMP9 and MCL1 levels of the women for their EP.The diagnostic efficacy of the serum MMP9 and MCL1 levels of the women combined with the ultrasound examination for their EP was calculated by the four-grid table.Results:Theβ-hCG level of the women in the study group was significantly lower than that of the women in the control group.The MCL1 level(9.08±2.10 ng/ml)of the women in the study group was significantly lower than that(13.62±3.03 ng/ml)of the women in the control group.The MMP9 level(406.25±64.18μg/L)of the women in the study group was significantly higher than that(334.56±51.39μg/L)in the control group(all P<0.05).The sensitivity and the specificity of the ultrasound for diagnosing EP of the women were 87.5%and 90.4%.Kappa test showed that the consistency between the ultrasound and the pathological for diagnosing EP was high(Kappa=0.780,P<0.001).The endometrial thickness of the women in the study group was significantly thinner than that of the women in the control group,and the values of RI and PI of the women in the study group were significantly higher than those of the women in the control group(all P<0.05).Multivariate logistic regression analysis showed that the increasedβ-hCG and MCL1 levels and the endometrial thickness of the women were the protective factors of their EP,and the increased MMP9 level and the RI and PI values of the women were the risk factors of their EP(all P<0.05).The sensitivity and the specificity of the MMP9 levels combined with the MCL1 level of the women for diagnosing their EP were 78.4%and 88.3%.The sensitivity and the specificity of the serum MMP9 and MCL1 levels combined with the ultrasound examination of the women for diagnosing their EP were 95.5%and 87.2%.Conclusion:The women with EP have higher serum MMP9 level and lower MCL1 level.The serum MMP9 and MCL1 levels combined with the ultrasound examination of the women for diagnosing their EP has the highest diagnostic sensitivity.
作者
郭晓波
游玉平
GUO Xiaobo;YOU Yuping(900th Hospital of Joint Logistic Support Center,Fuzhou,Fujian Province,350025)
出处
《中国计划生育学杂志》
2025年第6期1425-1430,共6页
Chinese Journal of Family Planning
关键词
异位妊娠
基质金属蛋白酶9
髓细胞白血病蛋白1
阴道超声
诊断效能
Ectopic pregnancy
Matrix metalloproteinase 9
myeloid cell leukemia l
Transvaginal ultrasound
Diagnostic efficacy
