子宫螺旋动脉血流参数检测联合血清孕酮、β-HCG测定预测早期先兆流产结局的价值

Values of detection of uterine spiral artery blood flow parameters combined with serum progesterone and β-HCG detection in prediction of outcomes of early threatened abortion

目的:探讨联合检测子宫螺旋动脉血流参数及血清激素(孕酮、β-HCG)在预测早期先兆流产预后中的价值。方法:选择305例孕龄在5～7周的单胎孕妇,根据妊娠结局分为3组,正常妊娠组169例,先兆流产组95例,难免流产组41例,经阴道彩超检测子宫螺旋动脉血流阻力指数(RI),采用放射免疫法测定血清孕酮和β-HCG。结果:正常组及先兆流产组血清孕酮、HCG均显著高于难免流产组(P<0.01);难免流产组子宫螺旋动脉RI值明显高于正常组及先兆流产组(P<0.01),以孕酮<15.5 mg/L、β-HCG<6015 U/L作为临界值,预测难免流产的灵敏度和特异度分别是78.7%、70.7%和61.1%、70.9%。以RI>0.53为临界值,预测难免流产的灵敏度、特异度是71.0%、86.1%。三者联合检测,预测难免流产灵敏度和特异度达94.4%和89.1%。结论:血清孕酮、β-HCG、子宫螺旋动脉RI值三者联合检测更具有优越性,可以提高难免流产的检出率,对比单项测定指标的预测准确率明显提高,具有重要的临床意义。

Objective：To explore the values of detection of uterine spiral artery blood flow parameters combined with serum hormones（progesterone and β-HCG） detection in prediction of pregnant women outcomes of early threatened abortion.Methods：305 pregnant women of single pregnancy and 5~7 gestational weeks were selected and divided into three groups according to pregnancy outcomes： 169 pregnant women in normal pregnancy group,95 pregnant women in threatened abortion group and 41 pregnant women in inevitable abortion group,color Doppler ultrasound was used to detect resistance index（RI） of uterine spiral artery blood flow,the serum levels of progesterone and β-HCG were detected by radioimmunoassay.Results：The serum levels of progesterone and β-HCG in normal pregnancy group and threatened abortion group were significantly higher than those in inevitable abortion group（P0.01）,the value of RI in inevitable abortion group was significantly higher than those in normal pregnancy group and threatened abortion group（P0.01）.Progesterone level15.5 mg/L and β-HCG level6 015.0 U/L were selected as critical values,the sensitivities and specificities to predict the outcomes of inevitable abortion were 78.7% and 70.7%,61.1% and 70.9%,respectively.RI0.53 was selected as critical value,the sensitivity and specificity to predict the outcomes of inevitable abortion were 71.0% and 86.1%,respectively.While joint detection of progesterone,β-HCG and RI,the sensitivity and specificity to predict the outcomes of inevitable abortion were 94.4% and 89.1%,respectively.Conclusion：Joint detection of serum progesterone,β-HCG and RI of uterine spiral artery blood flow has obvious superiority,which can increase the detection rate of inevitable abortion,compared with detection of single index,the accurate rate of diagnosis of joint detection increases significantly,thus,the method has important clinical significance.