摘要
目的:评价血β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、癌抗原125(CA125)及子宫内膜厚度(EST)对异位妊娠的诊断价值。方法:回顾性分析2006年6月至2009年5月在我院门诊或住院拟诊为异位妊娠并且资料齐全的患者152例的临床资料,所有患者均于就诊当天检测血β-HCG、P及CA125,并经阴道超声检测EST,48小时后再次检测血β-HCG,通过资料计算ROC曲线下面积(AUC)并确定各检测指标的最佳工作点(OOP)。结果:89例确诊为异位妊娠,24例为宫内早孕,27例为宫内早孕流产,12例为难免流产。ROC工作曲线显示,血β-HCG48h/0h的诊断准确度最高(AUC=0.85),其次为P(AUC=0.81),再次为EST(AUC=0.79),CA125的诊断准确度最低(AUC=0.76)。ROC曲线确定检测的OOP显示,血β-HCG48h/0h为0.55,P为36.25nmol/L,EST为10.50mm,CA125为30.05KU/L临界值时具有较好的异位妊娠诊断灵敏度和特异度。结论:各检测指标用于诊断异位妊娠的灵敏度和特异度有所差异,在诊断时可结合使用。
Objective：To evaluate the role of β-HCG,progesterone（P）,cancer antigen 125（CA125） and endometrial stripe thickness （EST） in the diagnosis of ectopic pregnancy （EP）.Methods：The clinical data of 152 pregnant women were retrospectively reviewed in our hospital from Jun 2006 to May 2009.Serum β-HCG,P and CA125 were measured at visiting day （0 h）,and EST were also tested by Transvaginal Ultrasound （TVS） at that time.The values of β-HCG were measured again 48 h later,ROC curve was established and optimal operating point （OOP） of four indexes was ascertained.Results：In all cases,89 were diagnosed as EP,24 were intrauterine pregnancy （IUP）,27 were threatened abortion and 12 were inevitable abortion.ROC curve showed that the highest accuracy rate in the diagnosis of EP was β-HCG 48 h/0 h（AUC=0.85）,the second was progesterone （AUC=0.81）,the third was EST （AUC=0.79）,the lowest was CA125（AUC=0.76）.In addition,ROC curve showed all OOPs as following：serum β-HCG 48 h/0 h was 0.55,P was 36.25 nmol/L,EST was 10.50 mm,CA125 was 30.05 KU/L.When the four parameters were in the upper critical value,it had the higher sensitivity and specificity in the diagnosis of EP.Conclusions：Every index has respective sensitivity and specificity in the diagnosis of EP,and we can combine using all of them.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2010年第10期759-762,共4页
Journal of Practical Obstetrics and Gynecology
关键词
异位妊娠
Β-人绒毛膜促性腺激素
孕酮
癌抗原125
子宫内膜厚度
Ectopic pregnancy
β-human chorionic gonadotrophin
Progesterone
Cancer antigen 125
Endometrial stripe thickness
