血清中孕酮水平在早期异位妊娠中的诊断价值

Diagnosis Value of Progesterone in Serum for Ectopic Pregnancy

目的探讨血清孕酮(progesterone)水平在早期异位妊娠(ectopic pregnancy,EP)诊断中的价值。方法前瞻性分析我科2006年7月～2011年1月确诊的早期异位妊娠的患者66例,同期宫内早孕患者121例。运用化学发光法检测异位妊娠和宫内早孕患者外周血孕酮的水平,比较两组孕酮水平的差异,计算孕酮诊断异位妊娠的敏感性和特异性,绘制受试者工作曲线(ROC)对诊断试验进行评价。结果异位妊娠组血清孕酮含量中位数为28.3nmol/L,宫内早孕组为66.2nmol/L,数据为偏态分布资料,经Wilcoxon秩和检验,两组差别有统计学意义(P<0.05);以36nmol/L为诊断异位妊娠的Cut-off值,诊断试验的敏感性和特异性分别为77.71%和68.49%,ROC曲线下面积(AUC)为0.84。结论血清孕酮检测可作为临床异位妊娠诊断的参考指标。

Objective To evaluate the diagnostic value of the peripheral blood progesterone in ectopic pregnancy.Methods Prospectively included 66 ectopic pregnancy and 121 intrauterine gestation women in our hospital from July 2006 to January 2011. Peripheral blood progesterone level of 187 pregnancy women were tested by enzyme linked immunosorbent chemiluminescence assay. The peripheral blood progesterone level of the two groups was compared. And ROC curve was used to analyse the diagnosis effect of progesterone. Results The median peripheral blood progesterone level of the ectopic pregnancy and intrauterine gestation were 28.3nmol/L and 66.2nmol/L respectively.Singificant differences of peripheral blood level progesterone was detected between the two groups （P 〈 0.05 ）.At the threshold of 36nmol/L, sensitivity and specificity of progesterone as a serologic marker were 77.71% and 68.49% respectively. The under-curve area （ AUC ） of progesterone was 0.84. Conclusion As a serologic marker progesterone could be used as reference for the diagnosis of ectopic pregnancy