摘要
目的检测β-人绒毛促性腺激素(β-hCG)、碱性磷酸酶(ALP)、癌胚抗原125(CA125)在宫外孕(EP)患者血清中表达水平,探讨经腹彩色超声联合β-hCG、ALP、CA125对EP的诊断价值。方法选取2023年6月—2024年4月西藏自治区人民医院妇产科门诊就诊的EP患者79例作为病例组,另选正常宫内妊娠孕早期女性82例作为对照组。测定2组受试者血清β-hCG、ALP、CA125水平,腹部彩色超声检查子宫内膜厚度、盆腔积液;采用Pearson相关分析病例组血清β-hCG、ALP、CA125与腹部彩色超声参数相关性;多因素Logistic回归分析EP发生的影响因素;受试者工作特征(ROC)曲线分析经腹彩色超声联合血清β-hCG、ALP、CA125对EP的诊断价值。结果病例组β-hCG、ALP低于对照组(t=21.390、19.690,P<0.001),CA125高于对照组(t=33.390,P均<0.001);与对照组比较,病例组子宫内膜厚度变薄(t=14.440,P<0.001);子宫内膜厚度与血清β-hCG、ALP呈正相关,与CA125水平呈负相关(r=0.685、0.632、-0.701,P均<0.001);多因素Logistic回归分析,子宫内膜增厚、血清β-hCG高以及ALP高水平是宫外孕发生的保护因素[OR(95%CI)=0.937(0.896~0.972)、0.873(0.804~0.948)、0.077(0.034~0.097)],血清CA125高水平、盆腔积液增多是宫外孕发生的危险因素[OR(95%CI)=1.232(1.161~1.307)、2.955(1.887~4.626)];子宫内膜厚度、盆腔积液、β-hCG、ALP、CA125及5项联合预测EP的AUC分别为0.843、0.802、0.942、0.843、0.916、0.988,5项联合优于各自单独预测效能(Z/P=2.370/0.018、2.147/0.032、2.001/0.039、1.990/0.046、2.676/0.007)。结论EP患者子宫内膜变薄、盆腔积液增多、血清β-hCG水平低、ALP水平低、CA125水平高,腹部彩色超声联合血清β-hCG、ALP、CA125水平检测可提高EP的诊断效能。
Objective To assess the serum expression levels of beta-human chorionic gonadotropin(beta-hCG),alkaline phosphatase(ALP),and carcinoembryonic antigen 125(CA125)in patients with ectopic pregnancy(EP),and to investigate the diagnostic value of transabdominal color Doppler ultrasound combined with beta-hCG,ALP,and CA125 for EP.Methods Seventy-nine EP patients who were admitted to the Gynecology Department of the Tibet Autonomous Region People's Hospital from June 2023 to April 2024 were selected as the case group,and 82 early pregnant women were selected as the control group.The levels ofβ-hCG,ALP,and CA125 in the serum of the two groups were measured,and the thickness of the endometrium and the amount of pelvic fluid were examined by transabdominal color Doppler ultrasound.The correlation between the serumβ-hCG,ALP,and CA125 levels and the ultrasound parameters was analyzed by Pearson correlation analysis.The influencing factors of EP occurrence were analyzed by multivariate logistic regression analysis.The diagnostic value of transabdominal color Doppler ultrasound combined with serumβ-hCG,ALP,and CA125 for EP was analyzed by receiver operating characteristic(ROC)curve.Results In the case group,the level ofβ-hCG,ALP were significantly lower than those in the control group(t=21.390,19.690,P<0.001).Conversely,the levels of CA125 was notably higher(t=33.390,P<0.001).Furthermore,compared with the control group,the endometrial thickness was observed to be significantly thinner in the case group(t=14.440,P<0.001).Additionally,a positive correlation was found between endometrial thickness and serumβ-hCG and ALP levels(r=0.685,0.632;P<0.001),while a negative correlation was observed with CA125 level(r=-0.701;P<0.001).Finally,multivariate logistic regression analysis showed that endometrial thickening,high serumβ-hCG levels,and high ALP levels were protective factors for ectopic pregnancy[OR(95%CI)=0.937(0.896-0.972),0.873(0.804-0.948),0.077(0.034-0.097)],while high serum CA125 levels and increased pelvic fluid were
作者
高琳
苏娜
王元胜
拉姆群尼
米玛
索朗曲珍
Gao Lin;Su Na;Wang Yuansheng;Lamuqunni;Mima;Suolangquzhen(Department of Ultrasound,Gynecology,Tibet Autonomous Region People's Hospital,Lhasa 850000,China)
出处
《疑难病杂志》
CAS
2024年第7期850-855,共6页
Chinese Journal of Difficult and Complicated Cases
基金
西藏自治区自然科学基金(XZ2023ZR-ZY12(Z))
中国医学科学院中央级公益性科研院所基本科研(2022-RW320-02)。
关键词
宫外孕
腹部彩色超声
血清β-人绒毛促性腺激素
碱性磷酸酶
癌胚抗原125
相关性
影响因素
Ectopic pregnancy
Abdominal color ultrasound
Serumβ-human chorionic gonadotropin
Alkaline phosphatase
Carcinoembryonic antgen 125
Relevance
Influence factor
