D-二聚体、可溶性细胞间黏附分子-1联合超声检测在胎盘早剥诊断中的价值

Diagnostic value of D-dimer and soluble intercellular adhesion molecule-1 combined with ultrasound in patients with placental abruption

目的:探索D-二聚体(D-Dimer)和可溶性细胞间黏附分子-1(sICAM-1)联合超声(Ultrasound)检测在胎盘早剥(Placental abruption)患者中的诊断价值.方法:选取180例孕妇为研究对象,其中胎盘早剥组72例,高危组59例,健康组49例.所有患者均行产前超声检查,并测定血清D-二聚体、sICAM-1的表达水平,绘制ROC曲线分析D-二聚体、sICAM-1联合超声诊断胎盘早剥的诊断效能.结果:胎盘早剥组胎盘增厚、胎盘边缘血肿、胎盘基底部不规则液性暗区和混合性强回声例数显著高于高危组和健康组(P<0.05);胎盘早剥组患者血清D-二聚体、sICAM-1的水平显著高于高危组和健康组(P<0.05);D-二聚体、sICAM-1和超声平行联合检测的灵敏度为86.1%,显著高于3者单独检测及平行联合检测的灵敏度(70.8%、62.5%、66.7%、73.6%)(P<0.05),同时约登指数(0.639)和准确度(81.1%)最高;ROC曲线显示:D-二聚体、sICAM-1和超声平行联合检测的ROC曲线下面积显著高于D-二聚体、sICAM-1和超声单独检测,有统计学差异(P<0.05).结论:D-二聚体、可溶性细胞间黏附分子-1联合超声检测可以提高对胎盘早剥患者的诊断效能,对临床诊断胎盘早剥具有重要价值.

Objective:To discuss the diagnostic value of D-Dimer and soluble intercellular adhesion molecule-1(sICAM-1)combined with ultrasound in patients with placental abruption.Methods:From May 2016 to May 2018,180 pregnant women admitted to our hospital were selected as the study subjects,including 72 cases in placental abruption group,59 cases in high-risk group and 49 cases in healthy group.Prenatal ultrasound examination was performed in all patients,and the expression level of D-dimer and sICAM-1 in serum was measured.ROC curve was plotted to analyze the efficacy of D-dimer and sICAM-1 combined with ultrasound in diagnosing placental abruption.Results:The number of cases with placental thickening,hematoma at the margin of placenta,irregular fluid dark area and mixed strong echo at the base of placenta in abruption group was significantly higher than that in high-risk group and healthy group(P<0.05).The level of D-dimer and sICAM-1 in serum of patients in placental abruption group was significantly higher than those in high-risk group and healthy group(P<0.05).The sensitivity of parallel detection of D-dimer,sICAM-1 and ultrasonic was 86.1%,which was significantly higher than that of the three detection alone and parallel detection(70.8%,62.5%,66.7%,73.6%)(P<0.05).The Youden index(0.639)and accuracy(81.1%)of parallel detection of the three items were the highest.ROC curve showed that the area under curve of parallel detection of D-dimer,sICAM-1 and ultrasound was significantly higher than that of D-dimer,sicam-1 and ultrasonic detection alone(P<0.05).Conclusion:D-dimer and soluble intercellular adhesion molecule-1 combined with ultrasound can improve the diagnostic efficacy of placental abruption patients.