阴道三维能量多普勒超声联合胚胎植入相关因子检测宫外孕的应用价值

Application value of transvaginal three-dimensional power Doppler ultrasound combined with embryo implantation related factors in detection of ectopic pregnancy

目的探讨阴道三维能量多普勒超声(3D-PDU)联合胚胎植入相关因子检测宫外孕的应用价值。方法选取妇科就诊的门诊拟诊宫外孕患者25例作为试验组,同期因个人原因需行人工流产的宫内妊娠25例作为对照组。对两组患者进行阴道3D-PDU,采用三维重建技术和VOCAL软件观察妊娠黄体血流分布,测量血管化指数(VI)、血流指数(FI)和血管化血流指数(VFI);抽取患者静脉血,采用酶联免疫法检测两组患者血清中胚胎植入相关因子(PROKs、h CG、VEGF和PIGF)的蛋白含量水平。结果与对照组比较,试验组患者的VI、VFI和PIGF均降低,差异有统计学意义(P<0.05),FI略降低但差异无统计学意义(P>0.05);试验组患者的PROKs、h CG、VEGF均升高,差异有统计学意义(P<0.05)。结论阴道3D-PDU能更为精确地反映患者妊娠黄体血流分布情况,联合检测患者血清中胚胎植入相关因子的蛋白含量水平,对更好的监测宫外孕的诊断符合率具有重要临床意义。

Objective To explore the application value of transvaginal three-dimensional power Doppler ultrasound （3D-PDU） com- bined with embryo implantation related factors in detection of ectopic pregnancy. Methods Twenty-five patients suspected of ectopic preg- nancy in Gynecological Outpatient of the hospital were included in experimental group. Meanwhile, 25 cases of intrauterine pregnancy who needed abortion due to personal reasons were selected as control group. The patients in the two groups received transvagina] 3D-PDU. Three-dimensional reconstruction technology and VOCAL software were used to observe blood flow distribution of corpus luteunl; vascular in- dex （VI） , blood flow index （FI） , and vascular blood flow index （VFI） were measured; vanous blood specimens were obtained, the serum levels of embryo implantation related factors （PROKs, hCG, VEGF, PIGF） in the two groups were detected by enzyme-linked immunosor- bent assay （ELISA） . Results Compared with control group, VI, VFI, and PIGF levels of patients in experimental group decreased signifi- cantly （ P〈0. 05 ）, while FI level slightly decreased without statistically significant difference （ P〉0. 05 ） ; PROKs, hCG, and VEGF levels in experimental group increased with statistically significant difference （ P〈0. 05 ） . Conclusion Transvaginal 3D-PDU can reflect blood flow distribution of corpus luteum more accurately, transvaginal 3 D-PDU combined with detection of serum protein levels of embryo implanta- tion related factors exhibits important clinical significance in better monitoring the diagnostic accordance rate for ectopic pregnancy.