彩超联合AFP在诊断凶险型前置胎盘合并胎盘植入中的应用价值

Application Value of Color Doppler Ultrasound Combined with AFP in the Diagnosis of Dangerous Placenta Previa Complicated with Placenta Implantation

目的:探讨彩色多普勒超声联合甲胎蛋白(AFP)诊断凶险型前置胎盘(PPP)合并胎盘植入的价值。方法:选取2016年3月-2018年10月笔者所在医院收治的100例PPP患者为研究对象,术后病理检查结果为PPP合并胎盘植入者45例,PPP非胎盘植入者55例。另外选取健康孕妇45例作为对照。采用化学发光免疫分析仪检测血清中AFP水平,用彩色多普勒超声诊断仪对孕晚期孕妇进行腹部和会阴超声检查。绘制ROC曲线分析诊断价值。结果:彩色多普勒超声检查显示,PPP为中央型45例、部分型39例、边缘型16例。胎盘植入患者血清AFP水平明显高于非植入患者和健康孕妇,差异有统计学意义(P<0.05)。彩色多普勒超声联合AFP诊断PPP合并胎盘植入的灵敏度和特异度分别为91.11%和80.00%,均高于单独诊断,差异有统计学意义(P<0.05)。联合诊断的ROC曲线下面积(0.871)均大于超声(0.701)和AFP单独诊断(0.799),差异均有统计学意义(P<0.05)。结论:彩色多普勒超声联合AFP诊断PPP合并胎盘植入的价值较高。

Objective:To investigate the value of color Doppler ultrasound combined with alpha fetoprotein(AFP) in the diagnosis of dangerous placenta previa(PPP) with placenta implantation.Method:From March 2016 to October 2018,100 patients with PPP were treated in our hospital.Postoperative pathological examination showed that there were 45 cases of PPP with placenta implantation and 55 cases of PPP without placenta implantation.Another 45 healthy pregnant women were selected as controls.The levels of AFP in serum were detected by chemiluminescence immunoassay(CLIA),and abdominal and perineal ultrasonography was performed by color Doppler ultrasonography(CDFI) in late pregnant women.Draw ROC curve to analyze diagnostic value.Result:Color Doppler ultrasonography showed that PPP was central in 45 cases,partial in 39 cases and marginal in 16 cases.The serum AFP level of placenta implantation patients was significantly higher than that of non-implantation patients and healthy pregnant women,the difference was statistically significant(P<0.05).The sensitivity and specificity of color Doppler ultrasound combined with AFP in the diagnosis of PPP with placental implantation were 91.11% and 80.00% respectively,which were higher than those of single diagnosis,the differences were statistically significant(P<0.05).The area under ROC curve(0.871) of combined diagnosis was larger than that under ultrasound(0.701) and AFP alone(0.799),the difference was statistically significant(P<0.05).Conclusion:CDFI combined with AFP is of high value in the diagnosis of PPP with placenta implantation.