血管内皮生长因子联合β-人绒毛膜促性腺激素检测对疑似异位妊娠的诊断价值

Diagnostic value of vascular endothelial growth factor combined with β-human chorionic gonadotropin for suspected ectopic pregnancy

目的 探讨血管内皮生长因子（VEGF）联合β-人绒毛膜促性腺激素（β-hCG）早期诊断异位妊娠的价值.方法 分别用双抗体夹心酶联免疫吸附法和放射免疫法测定109例疑似异位妊娠患者的血清VEGF和β-hCG水平,并建立受试者工作特征（ROC）曲线,分析VEGF和β-hCG检测对异位妊娠的诊断价值.结果 109例疑似异位妊娠患者最后确诊异位妊娠62例,宫内妊娠47例.异位妊娠患者血清VEGF水平明显高于宫内妊娠患者（P＜0.05）,而β-hCG水平明显低于宫内妊娠患者（P＜0.05）.VEGF的ROC曲线下面积为0.87,β-hCG的RO曲线下面积为0.71.以血清VEGF＞140 ng/L诊断异位妊娠,其灵敏度、特异度分别是75.8%（47/62）、80.9%（38/47）,以β-hCG＜1200 U/L诊断异位妊娠,其灵敏度、特异度分别是64.5%（40/62）、61.7%（29/47）.两者联合检测诊断异位妊娠的灵敏度、特异度分别是80.6%（50/62）、57.4%（27/47）.结论 血清VEGF对异位妊娠的早期诊断优于β-hCG,两者联合检测可提高异位妊娠早期诊断率,缩短观察时间.

Objective To explore the diagnostic values of vascular endothelial growth factor （VEGF） and p -human chorionic gonadotropin（ β -hCG） for early ectopic pregnancy. Methods The serum levels of VEGF and β-hCG were measured in 109 patients with suspected ectopic pregnancy by ELISA and RIA respectively, receiver operating characteristic （ROC） curvers were established, the diagnostic values of VEGF and β -hCG for ectopic pregnancy were analyzed. Results One hundred and nine patients with suspected ectopic pregnancy were diagnosed in the end： 62 cases with ectopic pregnancy and 47 cases with intrauterine pregnancy. The levels of VEGF in ectopic pregnancy were significantly higher than those in intrauterine pregnancy （P 〈 0.05）, but the levels of β -hCG were significantly lower than those in intrauterine pregnancy （P 〈 0.05）. The areas under ROC curves of VEGF were 0.87, the areas under ROC curves of β -hCG were 0.71. In VEGF 〉 140 ng/L for diagnosis of ectopic pregnancy, the sensitivity and specificity were 75.8% （47/62） and 80.9% （38/47） respectively. In β-hCG 〈 1200 U/L for diagnosis of ectopic pregnancy, the sensitivity and specificity were 64.5%（40/62） and 61.7%（29/47） respectively. The sensitivity and specificity of combined detection of VEGF and β -hCG were 80.6%（50/62） and 57.4%（ 27/47） respectively. Conclusions The diagnostic values of VEGF are better than those of β -hCG. The combined detection of VEGF and β -hCG can increase the rate of early diagnosis and shorten observation time.