β-HCG与孕酮检测联合阴道超声早期诊断异位妊娠的价值探讨

The diagnostic value of the detection of progesterone and β- HCG,combined with vaginal B ultrasound for early ectopic pregnancy

目的:探讨血清β-HCG变化规律及孕酮检测结果联合阴道B超在异位妊娠(EP)早期诊断的价值。方法:前瞻性病例对照研究,将用化学发光法测定血清β-HCG及孕酮的水平符合标准的可疑异位妊娠患者分别进行阴道B型超声(304例)和腹部超声检查(256例),以最终后穹窿穿刺抽出不凝血确诊或术后病理确诊异位妊娠为评判标准,比较两组诊断异位妊娠的符合率,诊断敏感性和特异性。结果:血清β-HCG+孕酮联合阴道B超诊断为异位妊娠的符合率为94.73%,敏感性和特异性分别为98.61%、97.84%,明显优于腹部B超+孕酮+血清β-HCG诊断为异位妊娠的符合率为89.19%,敏感性和特异性92.64%、94.14%,差异具有统计学意义(P<0.05)。结论:监测血清β-HCG变化规律及检测孕酮水平联合恰当时机阴道超声检查,对异位妊娠的早期诊断有重要的诊断价值。

Objective To explore the diagnostic value of serum β- HCG,progesterone and vaginal B ultrasound by Vagina in diferential. Diagnosis among ectopic pregnancy（ EP）. Method Prospectie case- control study,use chemiluminescence method to measure the serum levels of β- HCG and progesterone levels,Patients with suspected ectopic pregnancy were examined by vaginal ultransonography（ 304 cases） and abdominal ultransonography（ 256 cases）,After the vault puncture or postoperative pathological diagnosis of ectopic pregnancy as the judgment standard. The accuracy of diagnosis of ectopic pregnancy,diagnostic sensitivity and specificity of two groups were compared. Results The diagnosis corresponding rate was 94. 73% between the vaginal ultransonography ＋ β- HCG ＋ progesterone and the last result,the susceptibility and specificity were 98. 61% and 97. 84%,respectively. The abdominal ultransonography ＋ β- HCG ＋ progesterone corresponding rate was 89. 19% %,the susceptibility and specificity were92. 64% and 94. 14%,repectively. The result was better than the control group（ P〈0. 05）,the difference was statistically significant. Conclusion Vaginal ultrasound,serum progesterone and β- HCG joint diagnosis,three indicators for early ectopic pregnancy diagnosis accuracy is high,has important diagnostic value.