阴道超声联合血清β-HCG水平检测诊断宫外孕的价值研究

Clinical value of vaginal ultrasound combined with serum β-HCG level detection in diagnosis of ectopic pregnancy

目的探讨阴道超声联合血清人绒毛膜促性腺激素(β-HCG)诊断宫外孕的临床价值。方法选取2015年1月至2018年10月收治的61例宫外孕患者(宫外孕组)、61例同期宫内妊娠妇女(对照组),检测2组血清β-HCG水平,采用引导超声检测子宫内膜厚度;并对比2组的阴道超声检查特征;以最终临床确诊结果作为标准,计算血清β-HCG联合阴道超声检查鉴别诊断宫外妊娠的临床价值。结果宫外孕组患者的血清β-HCG、子宫内膜厚度显著的低于对照组,差异有统计学意义(P<0.05);绘制ROC曲线,求取血清β-HCG鉴别诊断宫外孕的临界值为2804.8 U/ml;宫外孕组的附件包块检出率、盆腔积液阳性率、子宫内膜厚度<10 mm、子宫内膜动脉RI≥0.4的患者检出率均显著的高于对照组(P<0.05),宫外孕组的宫内孕囊检出率现在低于对照组(P<0.05);阴道超声鉴别诊断宫外孕的灵敏度为93.44%、特异度为100%;血清β-HCG鉴别诊断宫外孕的灵敏度为75.41%、特异度为83.61%;阴道超声联合血清β-HCG鉴别诊断宫外孕的灵敏度为98.36%、特异度为98.36%。结论阴道超声对于鉴别诊断宫外孕的临床价值高于血清β-HCG检测,二者联合应用并不能显著的提高对宫外孕的诊断效能。

Objective To investigate the clinical value of vaginal ultrasound combined with serum human chorionic gonadotropin(β-HCG)detection in diagnosis of ectopic pregnancy.Methods Eighty-eight patients with ectopic pregnancy(ectopic pregnancy group)and 61 women with intrauterine pregnancy(control group)who were hospitalized in our hospital from January 2015 to October 2018 were enrolled in the study.The serum levels ofβ-HCG were detected and the endometrium thickness was measured by guided ultrasound.Moreover the characteristics of vaginal ultrasonography were observed and compared between the two groups,and the clinical value of serumβ-HCG combined with vaginal ultrasonography in differential diagnosis of ectopic pregnancy was evaluated based on the final clinical diagnosis.Results The serum levels ofβ-HCG and endometrial thickness in ectopic pregnancy group were significantly lower than those in control group(P<0.05).The ROC curve was drawn and the critical value of serumβ-HCG in differential diagnosis of ectopic pregnancy was 2804.8U/ml.The detection rate of accessory mass,the positive rate of pelvic fluid,the detection rates of endometrial thickness<10mm and the endometrial artery RI≥0.4 in ectopic pregnancy group were significantly higher than those in control group(P<0.05).The detection rate of intrauterine pregnancy sac in ectopic pregnancy group was significantly lower than that in control group(P<0.05).In addition the sensitivity of vaginal ultrasound in diagnosis of ectopic pregnancy was 93.44%and the specificity was 100%.The sensitivity of serumβ-HCG detection in differential diagnosis of ectopic pregnancy was 75.41%and the specificity was 83.61%.The sensitivity of vaginal ultrasound combined with serumβ-HCG in diagnosis of ectopic pregnancy was 98.36%,and the specificity was 98.36%.Conclusion The clinical value of vaginal ultrasound in differential diagnosis of ectopic pregnancy is higher than that of serumβ-HCG detection,however,the combination detection of the two indexes can not significantly improve the diagnostic efficacy for ectopic pregnancy.