异位妊娠患者血管内皮生长因子含量变化及临床价值

Changes and Clinical Significance of VEGF Contents in Patients with Ectopic Pregnancy

目的研究分析血管内皮生长因子(VEGF)在异位妊娠患者早期诊断中的价值。方法选取黄石市中心医院妇产科门诊2014年1月—2015年1月收集的67例异位妊娠患者(孕周<7周)作为异位妊娠组、同期正常妊娠者80例作为正常妊娠组,检测两组外周血VEGF及黄体酮(P)、人绒毛膜促性腺激素(β-h CG)的水平并进行比较,绘制受试者工作曲线(ROC),选取最大诊断指数时VEGF的临界值作为最佳诊断临界值。结果异位妊娠组血VEGF水平显著高于正常妊娠组(P<0.05),血β-h CG、黄体酮(P)水平显著低于正常妊娠组(P<0.05)。不同妊娠部位及胚胎类型异位妊娠患者VEGF、P、β-h CG水平存在差异(P<0.05,P<0.01)。通过绘制ROC曲线,发现在VEGF为50 pg/ml的情况下,诊断异位妊娠的灵敏度为0.826、特异度为0.927,同时具有最大的ROC曲线下面积(AUC)(0.918)及诊断指数(1.753)。结论外周血VEGF在异位妊娠患者中的表达明显上调,其检测值的变化可在一定程度上协助确诊。

Objective To study the value of vascular endothelial growth factor（ VEGF） in early diagnosis of patients with ectopic pregnancy.Methods A total of 67 patients with ectopic pregnancy（ gestational weeks〈 7 weeks）during January 2014 and January 2015 were selected as ectopic pregnancy group,and 80 normally pregnant women at the same period were selected as normal group.The levels of VEGF,progesterone（ P） and human chorionic gonadotropin（ β-h CG） in peripheral blood were detected and compared.The receiver operating curve（ ROC） was drawn,and VEGF critical value of maximal diagnosis index was used as the best critical value of diagnosis.Results In ectopic pregnancy group,the level of VEGF was significantly higher（ P〈0.05）,while the levels of β-h CG and P in peripheral blood were significantly lower than those in normal group（ P〈0.05）.There were significant differences in the levels of VEGF,P and β-h CG in ectopic pregnant patients with different pregnant positions and embryonic types（ P〈0.05,P〈0.01）.After the ROC was drawn,the diagnosed sensitivity of ectopic pregnancy was 0.826,the specificity was 0.927,and the largest area under curve（ AUC） of the ROC was 0.918,and the diagnostic index was 1.753 when the VEGF was50 pg / ml.Conclusion The significant up-regulation VEGF level can be found in peripheral blood of patients with ectopic pregnancy,and the value change may be helpful in confirming the ectopic pregnancy to a certain degree.