摘要
目的:分析超声筛查联合血清甲胎蛋白(AFP)、β-人绒毛膜促性腺激素(β-HCG)监测对产前胎盘植入诊断的价值。方法:选取行剖宫产术分娩且经超声诊断为有胎盘植入高危因素的136例单胎妊娠孕妇为研究对象,依据术后病理组织学诊断结果将研究对象分为胎盘植入组(n=62)及非胎盘植入组(n=74),另选取60名同期剖宫产分娩的无高危因素的单胎妊娠孕妇作为对照组。产前抽血测定孕妇AFP、β-HCG水平,并行彩色多普勒超声检查,利用受试者工作特征曲线(ROC曲线)比较超声、血清AFP、β-HCG水平及三者联合对产前胎盘植入的诊断价值。结果:与组织病理学结果对照,超声诊断产前胎盘植入准确率仅为77.42%;胎盘植入组和非胎盘植入组血清AFP(231.04±50.77、167.94±44.21)、β-HCG(351.74±53.60、218.87±47.22)水平均高于对照组(157.26±40.15、204.35±40.86),(P<0.05),胎盘植入组血清AFP、β-HCG水平高于非胎盘植入组(P<0.05);接受者操作特性曲线(ROC曲线)显示,超声联合血清AFP、β-HCG水平诊断产前胎盘植的敏感度(95.00%)、特异度(83.29%)及曲线下面积(AUC,0.874)均高于超声(77.42%、72.98%、0.774)和血清AFP(73.28%、70.64%、0.664)、β-HCG(68.00%、56.00、0.611)水平单独检测(P<0.05)。结论:超声联合血清AFP、β-HCG水平诊断产前胎盘植入价值较高,有一定应用价值。
Objective:To analyze the diagnostic value of ultrasound screening combined with serum alpha-fetoprotein(AFP)andβ-human chorionic gonadotropin(β-HCG)monitoring for prenatal placenta accreta.Methods:A total of 136 singleton pregnant women with high risk factors of placenta accreta were enrolled as the research objects(observation group).According to the results of postoperative histopathological diagnosis,they were divided into placenta accreta group(n=62)and placental non-accreta group(n=74).Another 60 singleton pregnant women without high risk factors were enrolled as the control group.Prenatal blood drawing was the conducted to determine levels of AFP andβ-HCG.And color Doppler ultrasound examination was conducted.The diagnostic value of ultrasound,serum AFP,β-HCG and their combination for prenatal placenta accreta were compared by receiver operating characteristic curve(ROC curve).Results:Compared with the histopathological results,the accuracy rate of ultrasonography in the diagnosis of prenatal placenta implantation was 77.42%.The levels of serum AFP andβ-HCG in placental accreta group(231.04±50.77,351.74±53.60)and placental non-accreta group(167.94±44.21,218.87±47.22)were higher than those in control group(157.26±40.15,204.35±40.86,P<0.05),which were higher in placental accreta group than in placental non-accreta group(P<0.05).ROC curve showed that the sensitivity,the sensitivity,specificity and AUC of ultrasonography combined with serum AFP andβ-HCG levels in the diagnosis of prenatal placenta implantation(95.00%,83.29%,0.874)were higher than those of ultrasound(77.42%,72.98%,0.774),serum AFP(73.28%,70.64%,0.664),andβ-HCG(68.00%,56.00,0.611)was detected separately(P<0.05).Conclusion:Diagnostic value of ultrasound combined with serum AFP andβ-HCG levels is high for prenatal placenta accrete,and has certain application value.
作者
李文敏
何雯
LI Wen-min;HE Wen(Department of Obstetrics and Gynecology,the Sixth People's Hospital of Chengdu,Chengdu 610051,Sichuan,China)
出处
《川北医学院学报》
CAS
2021年第6期723-726,共4页
Journal of North Sichuan Medical College
基金
国际多中心横向研究课题(HX-H1809169)。
关键词
胎盘植入
超声
甲胎蛋白
Β-人绒毛膜促性腺激素
Placental accreta
Ultrasound
Alpha-fetoprotein
β-human chorionic gonadotropin
