CA125、ADAM12-S、β-HCG及子宫内膜厚度对早期异位妊娠诊断的价值

Value of CA125,ADAM12-S,β-HCG and endometrial thickness measurement in the diagnosis of early ectopic pregnancy

目的:探讨短链解整合素-金属蛋白酶12(ADAM12-S)、血清癌抗原(CA125)、血清β-绒毛膜促性腺激素(β-HCG)及子宫内膜厚度在早期异位妊娠诊断中的价值。方法:收集我院2015年5月~2017年6月收治的已确诊的60例早期异位妊娠患者作为观察组,另收集我院同期行健康检查的正常宫内妊娠妇女60例作为对照组。分别采用化学发光法测定并对比两组的ADAM12-S、CA125、β-HCG水平,采用彩超检查并对比两组的子宫内膜厚度。结果:观察组患者血清中的ADAM12-S、CA125、β-HCG水平分别为(2.72±0.20)μg/L、(23.40±8.69)IU/m L、(1098.80±520.00)IU/L,均低于对照组的(18.67±0.91)μg/L、(73.12±12.60)IU/m L、(4185.00±2658.10)IU/L(P<0.05);观察组的子宫内膜厚度为(6.41±2.40)mm,低于对照组的(10.57±3.47)mm(P<0.05);ADAM12-S、CA125、β-HCG及子宫内膜厚度的灵敏度分别为78.30%、75.00%、72.50、74.20%;特异度分别为76.70%、73.30%、76.70%、81.70%。四项并联灵敏度提高,但特异度降低;四项串联特异度提高,但灵敏度降低;子宫内膜厚度与ADAM12-S、CA125及β-HCG水平均呈正相关(P<0.05)。结论:ADAM12-S、CA125、β-HCG及子宫内膜厚度四项均可作为临床诊断异位妊娠的有效指标,但若将四项联合检查,能够提升诊断符合率,对后续指导临床治疗具有重大价值。

Objective:To evaluate the value of ADAM12-S,CA125,β-HCG and endometrial thickness measurement in the diagnosis of early ectopic pregnancy.Methods:Sixty patients with early ectopic pregnancy diagnosed in our hospital between May 2015 and June 2017 were included in the observational group,and another 60 normal pregnancies undergoing physical examination in our department were recruited as controls.Chemiluminescence method was used to determine the levels of ADAM12-S,CA125 andβ-HCG,and color Doppler ultrasonography was performed to measure the thickness of endometrium in the two groups.Results:The serum levels of ADAM12-S,CA125 andβ-HCG were(2.72±0.20)μg/L,(23.40±8.69)IU/mL,and(1098.80±520.00)IU/L,respectively,in the observational group,which were significantly lower than those in the control group[(18.67±0.91)μg/L,(73.12±12.60)IU/mL,and(4185.00±2658.10)IU/L,P<0.05].Patients in the observational group had smaller thickness of endometrium than those in the control group[(6.41±2.40)mm vs.(10.57±3.47)mm,P<0.05)].The sensitivity of ADAM12-S,CA125,β-HCG and endometrial thickness was 78.30%,75.00%,72.50 and 74.20%,and the specificity 76.70%,73.30%,76.70%and 81.70%,respectively.Parallel test of the four indicators had significantly boosted the sensitivity,yet brought down the specificity.Contrarily,series test of the four indicators contributed to increased specificity,yet to decreased sensitivity.The thickness of endometrium was positively correlated with levels of ADAM12-S,CA125 andβ-HCG(P<0.05).Conclusion:ADAM12-S,CA125 andβ-HCG levels and endometrial thickness can be used as an effective index for clinical diagnosis of ectopic pregnancy,yet combined test of the four indicators can significantly improve the diagnostic rate,and be of great value in guiding following clinical treatment of this disorder.