摘要
目的应用诊断试验评价方法及受试者工作特征曲线(ROC曲线)评估经阴道能量多普勒超声(TV-PDU)对早期可疑异位妊娠(FP)的诊断价值。方法应用TV-PDU检查EP患者的子宫内膜形态学及血流动力学情况,测定患者血清β-HCG、β-HCG比值及血清孕酮(血清P),建立ROC曲线并确定各超声参数及临床指标以预测判断EP的最佳阈值,选择能够区分EP与非EP的一系列循证诊断指标的最佳水平,评价各指标对EP诊断的准确性。结果通过ROC曲线确定早期诊断EP的临界值:β-HCG为507.5 U/L国;β-HCG比值为1.592,血清P为24.50 nmol/L,子宫内膜厚度为10.5 nm。血清P是预测EP的最佳指标,具有更高的敏感度和特异度,与EP的相关性较好。ROC曲线下面积比较,血清P、内膜下动脉阻力指数(RI)及收缩期峰值流速(PSV)值较大,分别为0.940、0.941及0.948,能更好地筛查出早期可疑EP患者。结论应用ROC曲线确定相关临床资料及超声变量的临界值对可疑EP患者的预测有一定的临床意义。TV-PDU与血清P相结合可早期诊断EP,为临床诊断、治疗和随访提供一定帮助。
Objective To evaluate the diagnostic value of transvaginal power Doppler ultrasound（TV-PDU） combining the diagnostic test and receiver operating characteristics curves （ROC） on early ectopic pregnancy（EP）. Methods The morphology of endometrium and subendometrial hemodynamics were detected by TV-PDU. A blood sample of all the patients suspected of EP was taken to quantify the serum concentration of human chorionic gonadotropin （HCG） and progesterone （P）. ROC was constructed and the cut-off value of endometrial sonographic findings and clinical data in diagnosis of ectopic pregnancy was studied, and the accuracy of every variable was evaluated. Results Cut-off value of the thickness of the endometrium, the serum concentration of β-HCG and P, and β-HCG ratio were 10.5 mm, 507.5 U/L, 24.50 nmol/1 and 1. 592, respectively. The serum concentration of P predicted the EP well with higher sensitivity and specificity. The area under the ROC of subendometrial hemodynamics（RI,PSV） and the serum concentration of P was larger than other variables. Condusion Cut-off value of sonographic variables and clinical data can be analyzed by ROC. Early ectopic pregnancy（EP） could be predicted and diagnosed by TV-PDU combining the diagnostic test and ROC ,which is benefit for the clinical diagnosis, treatment and follow up.
出处
《临床超声医学杂志》
2008年第2期83-87,共5页
Journal of Clinical Ultrasound in Medicine
