摘要
目的探讨产前肌酸激酶(CK)检测辅助B超检查在胎盘植入诊断中的价值,为临床诊治提供参考依据。方法回顾性分析盐城市妇幼保健院80例疑似胎盘植入孕妇的临床病例资料,所有产妇产前均行CK检测和B超检查,分析产前CK检测辅助B超检查诊断胎盘植入的临床价值,与手术病理结果对照,比较B超检查与B超检查联合CK检测诊断胎盘植入的准确性。结果手术病理证实32例胎盘植入,48例未植入,Logistics多因素回归分析显示CK是胎盘植入的独立危险因素(P<0. 05),产前CK检测判断胎盘植入的最佳截断值为161. 5 U/L (AUC=0. 636,标准误=0. 065,95%CI=0. 508～0. 763,P=0. 041),产前B超检查诊断胎盘植入与手术病理结果一致性一般(Kappa值为0. 600,P<0. 05)。产前B超检查联合CK检测诊断胎盘植入与病理结果一致性满意(Kappa值为0. 815,P<0. 05)。产前超声检查联合CK检测诊断胎盘植入的准确度、敏感度、特异度、阳性预测值及阴性预测值均高于单纯超声检查,其中准确度差异有统计学意义(P<0. 05)。结论产前CK检测超过161. 5 U/L可作为判断产前胎盘植入的临床界值,CK检测辅助B超检查能提高诊断胎盘植入的准确性,具有较高临床应用价值。
Objective To study the value of creatine kinase test and B uhrasound in prenatal to diagnosis of placenta increta. Meth- ods The clinical data of 80 cases of suspected placenta increta in our hospital were analyzed retrospectively, all parturients were examined by CK and B ultrasonography antenatal, the clinical value of prenatal CK detection and B ultrasonic diagnosis of placenta accreta were ana- lyzed, the diagnostic accuracy of B ultrasound and B ultrasound combined with CK in placenta acereta was compared. Results 32 cases of placenta increta were confirmed by operation and pathology, 48 cases were not implanted. The logistic multivariate regression analysis showed thai CK was an independent risk factor for placenta increta （ P 〈 0. 05 ） , the best cutoff value of prenatal CK for placenta increta was 161.5 U/L （AUC =0. 636, 13 =0. 065, 95% CI = 0. 508 - 0. 763, P = 0. 041 ） , the consistency was commonly between B ultrasonic and operative pathological findings to diagnose the placenta increta （ Kappa = 0. 600, P〈0. 05 ） , the consistency was satisfied between B ultrasonic combined with CK and operative pathological findings to diagnose the placenta increta （Kappa=0. 815, P〈0.05） . The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of prenatal ultrasonography combined with CK in diagnosis of placenta accreta were higher than those of ultrasonography alone, the difference of accuracy was remarkable （ P〈0.05 ）. Conclusion The CK prenatal over 161.5U/L could be used as a clinical marker for placenta inereta, the CK examination assisted B ultrasonography could improve the accuracy of diagnosis of placenta increta, it has high clinical value.
作者
吴海燕
毕红
曹森杨
WU Hai-Yan;BI Hong;CAO Sen-Yang(Yancheng Maternal and Child Health Care Hospital,Yancheng,Jiangsu 224002,China)
出处
《中国妇幼保健》
CAS
2018年第21期4996-4999,共4页
Maternal and Child Health Care of China
基金
盐城市医学科技发展计划项目(YK2016040)
关键词
胎盘植入
肌酸激酶
B超
诊断
Placenta increta
CK
B ultrasonography
Diagnosis
