摘要
目的:探究超声测定子宫内膜厚度与雌二醇(E2)、妊娠相关蛋白A(PAPP-A)联合检测在早期异位妊娠诊断中的应用价值。方法:选择本院妇科2016年2月-2017年2月收治的疑似早期异位妊娠的患者186例,经病理学检查或手术检查确诊的64例为观察组,其他122例作为对照组。比较两组子宫内膜厚度、E2和PAPP-A水平的差异。评估子宫内膜厚度、E2、PAPP-A联合诊断早期异位妊娠的价值。结果:子宫内膜厚度为9.33mm时,Youden指数最大,其诊断早期异位妊娠的敏感度76.6%,特异度74.6%,ROC曲线下面积0.723。E2为1985.43 pmol/L时,Youden指数最大,其敏感度65.6%,特异度79.5%,ROC曲线下面积0.75。PAPP-A为21.33mU/L时,Youden指数最大,其敏感度为100.0%,特异度为77.0%,ROC曲线下面积0.864。以子宫内膜厚度≤9.33mm、E2≤1985.43 pmol/L、PAPP-A≤21.33mU/L联合诊断早期异位妊娠的敏感为92.20%,特异度82.8%,ROC曲线下面积0.922。结论:子宫内膜厚度、E2、PAPP-A联合检测可提高早期异位妊娠的诊断价值。
Objective:To explore value of endometrial thickness measured by ultrasound,combined with the detections of estradiol(E2)and pregnancy-associated protein A(PAPP-A)for diagnosing early ectopic pregnancy.Methods:186 patients with suspected ectopic pregnancy were selected.Among them,64 patients with diagnosed ectopic pregnancy by pathology or surgical examination were included in observation group and the other 122 patients were included in control group.The difference of the endometrial thickness measured by ultrasound and the levels of E2 and PAPP-A of the women were compared between the two groups.The value of endometrial thickness,E2 level,PAPP-A level,and the combination of endometrial thickness and the levels of E2 and PAPP-A for diagnosing early ectopic pregnancy were assessed.Results:When endometrial thickness was 9.33 mm,Youden index was the highest,and the sensitivity,the specificity,and area under ROC curve for diagnosing early ectopic pregnancy were 76.6%,74.6%,and 0.723.When E2 level was 1985.43 pmol/L,Youden index was the highest,and the sensitivity,the specificity,and area under ROC curve for diagnosing early ectopic pregnancy were 65.6%,79.5%,and 0.75.When PAPP-A was 21.33 mIU/L,the Youden index was the highest,and the sensitivity,the specificity,and area under ROC curve the combination of endometrial thickness and the levels of E2 and PAPP-A for diagnosing early ectopic pregnancy were were 100.0%,77.0%,and 0.864.When endometrial thickness≤9.33 mm,E2 level≤1985.43 pmol/L,and PAPP-A level≤21.33 mU/L,the sensitivity,specificity,and area under ROC curve of the combination of endometrial thickness and the levels of E2 and PAPP-A for diagnosing early ectopic pregnancy were 92.20%,82.8%,and 0.922.Conclusion:The combination of endometrial thickness measured by ultrasound and the levels of E2 and PAPP-A for diagnosing early ectopic pregnancy can improve the diagnostic value.
作者
赵骏达
古力其曼·艾孜木江
马俊旗
ZHAO Junda;GULIQIMAN·Aizimujiang;MA Junqi(The First Affiliated Hospital Of Xinjiang Medical University,Urumqi,Xinjiang,830054)
出处
《中国计划生育学杂志》
2021年第5期980-982,987,F0003,共5页
Chinese Journal of Family Planning
基金
国家自然科学基金(81960463)。
关键词
异位妊娠
子宫内膜厚度
雌二醇
妊娠相关蛋白A
Ectopic pregnancy
Endometrial thickness
Estradiol
Pregnance-associated protein A
