超声联合肌酸激酶和甲胎蛋白监测对凶险型前置胎盘合并胎盘植入的诊断价值

Value of Ultrasound Combined with CK and AFP Monitoring in Diagnosis of Patients with Pernicious Placenta Previa Complicated by Placenta Accreta

目的探讨超声联合肌酸激酶(CK)和甲胎蛋白(AFP)监测对凶险型前置胎盘合并胎盘植入的诊断价值。方法选取2015年6月—2016年12月收治的凶险型前置胎盘患者98例作为研究对象。根据是否合并胎盘植入分为植入组42例和非植入组56例。并选取同时期45例正常孕妇为对照组。以临床病理结果为金标准,计算不同诊断方法的灵敏度、特异度、阴性预测值、阳性预测值及诊断符合率。结果植入组血清CK和AFP水平明显高于非植入组和对照组(P <0. 05),而非植入组与对照组比较差异无统计学意义(P> 0. 05)。不同前置胎盘类型孕妇血清CK和AFP水平比较差异无统计学意义(P> 0. 05)。超声联合CK和AFP监测诊断凶险型前置胎盘合并胎盘植入的灵敏度均高于其他单纯检测(P <0. 05)。结论超声联合CK和AFP监测对凶险型前置胎盘合并胎盘植入的诊断灵敏度高。

Objective To investigate value of ultrasound combined with creatine kinase(CK)and alpha-fetoprotein(AFP)monitoring in diagnosis of patients with pernicious placenta previa complicated by placenta accreta.Methods A total of 98 patients with pernicious placenta previa admitted during June 2015 and December 2016 were divided into implantation group(n=42)and non-implantation group(n=56)according to whether or not having combination of placenta implantation,and other 45 normal pregnant women at the same period were selected as control group.The sensitivity,specificity,negative predictive value,positive predictive value and diagnostic coincidence rate of different diagnostic methods were calculated according to clinicopathological results as gold standard.Results Serum CK and AFP levels in implantation group were significantly higher than those in non-implantation and control groups(P<0.05),but there were no significant differences in the levels between non-implantation group and control group(P>0.05).There were no significant differences in serum CK and AFP levels among pregnant women with different types of placenta previa(P>0.05).The sensitivity of ultrasound combined with CK and AFP monitoring in diagnosis of patients with pernicious placenta previa complicated by placenta accreta is higher than those by other simple tests(P<0.05).Conclusion Ultrasound combined with CK and AFP monitoring in diagnosis of patients with pernicious placenta previa complicated by placenta accreta may achieve good sensitivity.