子宫内膜厚度、绒毛膜促性腺激素、孕酮联合诊断早期异位妊娠价值

The value of monitoring endometrial thickness by ultrasound combined with levels ofβhCG and progesterone for diagnosing women with early ectopic pregnancy

目的:探讨超声监测子宫内膜厚度联合检测绒毛膜促性腺激素(βhCG)、孕酮(P)诊断早期异位妊娠价值。方法:收集2016年5月—2018年9月本院收治的早期异位妊娠患者84例,完全自发性先兆流产82例及正常妊娠80例资料。对比不同指标诊断符合率,并以ROC曲线分析诊断效能。结果:3组中异位妊娠组βhCG、P水平最低,子宫内膜厚度最薄(P<0.05)。对异位妊娠诊断,βhCG截断值为821.09 U/L,AUC为0.752,P=0.031,灵敏度为83.2%,特异度为92.1%;P截断值为18.09 nmol/L,AUC为0.010,P=0.008,灵敏度为81.8%,特异度为90.3%;子宫内膜厚度截断值为6.70 mm,AUC为0.704,P=0.001,灵敏度为73.3%,特异度为81.7%。联合诊断相符率最高(P<0.05)。结论:子宫内膜厚度、βhCG及P联合监测可显著提升异位妊娠早期诊断率。

Objective:To explore the value of monitoring endometrial thickness by ultrasound combined with levels ofβhCG and progesterone(P)for diagnosing women with early ectopic pregnancy.Methods:84 women with early ectopic pregnancy(group A),82 women with spontaneous abortions(group B),and 80 normal pregnant women(group C)were enrolled in this study from May 2016 to September 2018.The diagnostic accuracy was compared among different indicators,and ROC curve was used for evaluating the diagnostic efficiency.Results:The levels ofβhCG and P,and endometrial thickness of women in group A were the lowest among the three groups(P<0.05).The ROC curve analysis showed that the cut off value ofβhCG level for diagnosing ectopic pregnancy was 821.09 U/L and AUC was 0.752(P=0.031),and its sensitivity and specificity were 83.2%and 92.1%.The cut off value of P level for diagnosing ectopic pregnancy was 18.09 nmol/L and AUC was 0.010(P=0.008),and its sensitivity and specificity were 81.8%and 90.3%.The cut off value of endometrial thickness for diagnosing ectopic pregnancy was 6.70 mm and AUC was 0.704(P=0.001),and its sensitivity and specificity were 73.3%and 81.7%.The coincidence rate of endometrial thickness by ultrasound combined with levels ofβhCG and P for diagnosing women with early ectopic pregnancy was the highest(P<0.05).Conclusion:The endometrial thickness by ultrasound combined with levels ofβhCG and P can significantly improve the early diagnosis rate of ectopic pregnancy,and can reduce missed diagnosis and misdiagnosis.