血清β-HCG、孕酮及癌抗原125联合阴道彩色多普勒超声对异位妊娠早期诊断的价值分析

Analysis of the value of β-HCG,progesterone and cancer antigen 125 combined with transvaginal color Doppler ultrasound in the early diagnosis of ectopic pregnancy

目的分析血清β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)、孕酮(progesterone,P)、癌抗原125(cancer antigen 125,CA125)联合阴道彩色多普勒超声对异位妊娠(ectopic pregnancy,EP)的早期诊断价值。方法选取2017年1月至2018年1月本院收治的90例疑似EP孕妇纳入EP组,另选取同期于本院进行孕检的经超声证实为宫内妊娠(intrauterine pregnancy,IUP)的90例孕妇纳入IUP组,60例妊娠10周内自然流产(abnormal intrauterine pregnancy,a IUP)孕妇纳入aIUP组。三组研究对象均行血清β-HCG、P、CA125水平检测及阴道彩色多普勒超声检查,EP组孕妇均行腹腔镜手术探查,以探查结果为准,比较不同检查方法对EP的诊断价值。结果 EP组孕妇血清β-HCG、P、CA125水平均显著低于IUP组和aIUP组(P_均<0.05),aIUP组孕妇上述指标水平均显著低于IUP组(P_均<0.05)。β-HCG、P、CA125诊断EP的截断点分别为4760.95 IU/L、17.20μg/L、34.94 mU/L,曲线下面积分别为0.802、0.834、0.793,诊断灵敏度分别为73.56%、81.61%、78.16%,特异度分别为100.00%、100.00%、66.67%,准确度分别为74.44%、82.22%、77.78%。血清β-HCG+P+CA125+阴道彩色多普勒超声检测诊断EP的灵敏度、准确度及阴性预测值均最高,特异度、阳性预测值与β-HCG+P检测、β-HCG+P+CA125检测相同,均为100.00%。结论血清β-HCG、P及CA125联合阴道彩色多普勒超声可提高早期EP检出率,具有较高临床价值。

Objective To analyze the value of serum 13-human chorionic gonadotropin （13-HCG）, progesterone （P） and cancer antigen 125 （CA125） combined with txansvaginal color Doppler ultrasound in the early diagnosis of ectopic pregnancy （EP）. Method A total of 90 pregnant women suspected EP in our hospital from January 2017 to January 2018 were selected as research objects, and they were included in EP group. Another 90 pregnant women with intrauterine pregnancy （IUP） during the same period in our hospital were included in IUP group and 60 pregnant women with abnormal intrauterine pregnancy （aIUP） were included in aIUP group. Serum β-HCG, P, CA125 levels and transvaginal color Doppler ultrasound were detected among all the objects, all pregnant women in EP group accepted laparoscopic surgery, based on the results of the surgery, the results and values of different examination methods in the diagnosis of EP were compared. Result The levels of serum β-HCG, P and CA125 in EP group were significantly lower than those in IUP group and aIUP group （Pall 〈 0.05）, and the above indexes in aIUP group were significantly lower than those in IUP group （Pall 〈 0.05）. The cut-off values of β-HCG, P and CA125 for diagnosis of EP were 4760.95 IU/L, 17.20 μg/L and 34.94 mU/L, respectively; the areas under the curve were 0.802, 0.834 and 0.793, respectively; the sensitivities were 73.56%, 81.61%, 78.16%, the specificities were 100.00%, 100.00% and 66.67%, the accuracy rates were 74.44%, 82.22% and 77.78%, respectively. The sensitivity, accuracy and negative predictive value of serum β-HCG ＋ P ＋ CA125 combined with transvaginal color Doppler ultrasound were the highest, and the specificity and positive predictive value were the same as β-HCG ＋ P and β-HCG ＋ P ＋ CA125. Conclusion Serum β-HCG, P and CA125 combined with transvaginal color Doppler ultrasound can improve the detection rate of early EP, which has high clinical value and is worthy of popularization and application.