联合血清标记物检测对早期异位妊娠的诊断价值

Diagnostic Value of Serum Markers to Earlier Ectopic Pregnancy

目的通过检测血清血管内皮生长因子(VEGF)、血清孕酮(P)在异位妊娠(EP)、自然流产(aIUP)及宫内早孕(IUP)组中的不同浓度,探讨VEGF、P及VEGF/P在停经早期鉴别EP和aIUP的意义。方法选择孕5～7周以内的30例EP患者、30例aIUP患者及30例IUP(对照组)妇女,采用酶联免疫聚合反应(ELLSA)检测血清VEGF浓度,采用Access免疫分析系统定量检测P浓度,并运用公式VEGF/P计算,进行对比分析,确定EP的诊断界值。结果EP组、aIUP组及IUP组血清VEGF浓度、P浓度分别为(321.54±32.38)pg/ml、(7.27±4.78)ng/ml;(140.33±21.98)pg/ml、(15.38±3.85)ng/ml和(60.37±9.74)pg/ml、(31.80±6.83)ng/ml,分别比较,差异有极显著性(P<0.01)。经公式VEGF/P计算后三组所得值分别为(74.34±14.62)、(9.65±3.83)和(2.06±0.81),差异有极显著性(P<0.01)。当VEGF/P>18时,诊断EP的敏感度为96.97%,特异度为96.56%,为诊断EP较好界值。结论血清VEGF及P浓度检测,通过公式VEGF/P计算,对早期EP具有较好的诊断价值,可用于早期EP与aIUP的鉴别诊断。

Objective To detect the different concentrations of serum vascular endothelial growth factor （VEGF） and progesterone （P） in the ectopic pregnancy （EP）, intrauterine pregnancy and spontaneous abortion. To study the differential diagnosis significance of serum P, VEGF and VEGF/P in earlier ectopic pregnancy and spontaneous abortion. Methods Pregnant women less than five-seven weeks were selected, 30 cases of EP patients, 30 cases of spontaneous abortion and 30cases of spontaneous abortion （control group）, and serum VEGF concentrations were detected by using enzyme-linked immunosorbent assay （ELISA）. The quantitative detection of serum progesterone was done by using Access immune analytical system, and calculated the VEGF/P. Carrying out contrast analysis to determine the diagnostic dividing value of EP. Resdts Serum concentrations of VEGF and P in EP, alUP and IUP were 321.54±32.38 pg/ml and 7.27±4.78 ng/ml, 140.33±21.98 pg/ml and 15.38±3. 85 ng/ml, and 60.37±9.74 pg/ml and 31.38±6.83 ng/ml, respectively. There were statistic significant （P〈0.01）. The calculation value of formula for VEGF/P from the three groups were 74.34±14.62, 9.65±3.83 and 2.06±0.81. There also were statistic significant （P〈0. 01）. The sensitivity to EP diagnosis was 96. 97% and the specificity was 96.56% when the value of VEGF/P〉18 which was suitable value for the diagnosis of EP. Conclusion It was good diagnostic value for the earlier ectopic pregnancy to detect Serum VEGF, progesterone concentration and calculate through formula VEGF/P, and can be used for the differential diagnosis of early intrauterine, ectopic pregnancy and spontaneous abortion.