摘要
目的:探讨彩色多普勒超声联合血清妊娠相关血浆蛋白A(PAPP-A)、抑制素A(INHA)、可溶性人类白细胞抗原G(sHLAG)在先兆流产诊断和预后中的价值。方法:选取108例先兆流产患者为研究对象,按治疗后妊娠结局分为继续妊娠组(65例)和流产组(43例),另选同期产检正常的健康孕妇为对照组(60例)。比较三组血清PAPP-A、sHLAG、INHA水平及子宫动脉搏动指数(PI)、阻力指数(RI)、收缩期最高流速与舒张最低流速比(S/D),受试者工作特征曲线(ROC)分析血清PAPP-A、sHLAG、INHA及子宫动脉PI、RI、S/D单独和联合对先兆流产的诊断和预测价值。结果:108例先兆流产患者经保胎治疗10d,保胎失败43例,保胎成功65例。子宫动脉PI、RI、S/D值比较,流产组高于继续妊娠组,继续妊娠组高于对照组,血清PAPP-A、sHLAG水平比较,对照组高于继续妊娠组,继续妊娠组高于流产组,INHA水平流产组高于继续妊娠组,继续妊娠组高于对照组(均P<0.05)。血清PAPP-A、sHLAG、INHA和超声指标联合对先兆流产的诊断AUC较各指标单独诊断AUC升高(均P<0.05)。结论:彩色多普勒超声及血清PAPP-A、sHLAG、INHA联合对先兆流产的诊断及预后评估价值较高。
Objective:To investigate the value of color Doppler ultrasound combined with serum pregnancy-associated plasma protein-A(PAPP-A),Inhibin-A(INHA)and soluble human leukocyte antigen G(sHLAG)in the diagnosis and prognosis of threatened abortion.Methods:A total of 108 patients with threatened abortion were selected as the study subjects,According to the pregnancy outcome after treatment,the patients were divided into continuing pregnancy group(65 cases)and abortion group(43 cases),and 60 healthy pregnant women with normal labor examination during the same period were selected as the control group.The levels of PAPP-A,sHLAG and INHA,the values of uterine artery blood flow Pulse Index(PI)and Resistance Index(RI),and the ratio of maximum systolic flow rate to minimum diastolic flow rate(S/D)were compared among the three groups.The predictive value of PAPP-A,sHLAG,INHA and PI,RI and S/D alone and combined in the diagnosis and prognosis of threatened abortion was analyzed by receiver operating characteristic(ROC)curve.Results:A total of 108 patients with threatened abortion were treated with tocolysis for 10 days,43 cases failed and 65 cases succeeded.The values of uterine artery blood flow PI,RI and S/D in the control group were lower than those in the continuing pregnancy group and the abortion group,the values of uterine artery blood flow PI,RI and S/D in the abortion group were higher than those in the continuing pregnancy group.The levels of serum PAPP-A and sHLAG in the continuing pregnancy group and the abortion group were lower than those in the control group,and the level of INHA was higher than that in the control group.The levels of serum PAPP-A and sHLAG in the abortion group were lower than those in the continuing pregnancy group,and the level of INHA was higher than that in the continuing pregnancy group(all P<0.05).ROC curve analysis showed that the area under the curve of the combined detection of serum PAPP-A,sHLAG,INHA and uterine artery blood flow PI,RI,S/D in the diagnosis and prognosis evaluation of threatened abortion was higher than that of each index alone(all P<0.05).Conclusion:Color Doppler ultrasound combined with serum PAPP-A,sHLAG and INHA can be used in the diagnosis and prognosis assessment of threatened abortion,and the test has high energy efficiency.
作者
陈寅
孙惟靖
张强
CHEN Yin;SUN Weijing;ZHANG Qiang(Department of Ultrasound Medicine,Yancheng Third People’s Hospital,Yancheng 224000,China)
出处
《陕西医学杂志》
CAS
2024年第1期42-45,共4页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(82173519)
江苏省自然科学基金资助面上项目(BK20181235)。
