B超与血清高敏C反应蛋白、D-二聚体和胰岛素抵抗水平联检诊断卵巢肿瘤的临床评价

Clinical Value of Diagnosis on B-Ultrasonography Combined Determination with Serum hs-CRP, D-D and IR in Patients with Ovarian Tumor

目的 探讨B超与血清高敏C-反应蛋白（high-sensitive C-reactive protein,hs-CRP）、D-二聚体（D-dimer,D-D）和胰岛素抵抗（insulin resistance,IR）联检诊断早期卵巢癌和进行卵巢良恶性肿瘤鉴别诊断的临床价值.方法 63例卵巢癌患者和62例卵巢良性肿瘤患者进行彩色多普勒超声检查,采用荧光免疫干式法和免疫比浊法测定卵巢癌和卵巢良性肿瘤患者及60名健康对照的血清hs-CRP、D-D、空腹血糖（fasting blood glucose,FBG）和空腹胰岛素（fasting insulin,FIns）水平,并进行对比性研究.结果 63例卵巢癌患者彩超诊断符合率为96.8％,彩超检查征象以形态不规则为主.卵巢癌患者血清hs-CRP水平高于卵巢良性肿瘤患者和对照组（P均〈0.01）.卵巢癌患者血清D-D水平高于卵巢良性肿瘤患者和对照组（P均〈0.01）.卵巢癌患者稳态模型胰岛素抵抗指数（homeostasis model assessment index of insulin resistance,HOMA-IR）高于卵巢良性肿瘤患者和对照组（P〈0.05,P〈0.01）.结论 彩色B超具有卵巢良恶性肿瘤患者鉴别诊断的临床价值.血清hs-CRP、D-D和HOMA-IR不仅是早期诊断的指标,而且具有卵巢良恶性肿瘤鉴别诊断的临床意义.

Objective To explorer clinical value of early diagnosis and differential diagnosis on B-ultrasound combined with serum high-sensitive C-reactive protein （hs-CRP）, D-dimer （D-D） and insulin resistance （IR） in patients with ovarian tumor. Methods 63 patients with ovarian cancer and 62 patients with benign ovarian tumor were analyzed by color Doppler ultrasonography. The serum hs-CRP, D-D, fasting blood glucose （FBG） and fasting insulin （Fins） were determined by dry immunofluorescence and immunoturbidimetry and compared analysis was done. Results The diagnosis accuracy rate of color Doppler ultrasonography in 63 cases of ovarian cancer was 96.8%. Color Doppler sonographic signs are mainly irregular in shape. The serum hs-CRP levels in patients with ovarian cancer were significantly higher than those in patients with benign ovarian tumor and healthy controls （all P 〈 0.01）. The serum D-D levels in patients with ovarian cancer were significantly higher than those in patients with benign ovarian tumor and healthy controls （all P 〈 0.01）. The serum HOMA-IR in patients with ovarian cancer was significantly higher than that in patients with benign ovarian tumor and healthy controls （P 〈 0.05, P 〈 0.01）. Conclusion Color Doppler ultrasonography had clinical value of differential diagnosis in ovarian benign and malignancy tumor. The serum hs-CRP, D-D and HOMA-IR not only were index of early diagnosis, but also were clinical significance of differential diagnosis in ovarian benign and malignancy tumor.