B超联合血清β-HCG、孕酮、雌二醇和AFP水平检测对异位妊娠的诊断价值

Diagnostic value of b-ultrasound combined with serum levels of beta-hcg,progesterone,estradiol and AFP in ectopic pregnancy

目的探讨B超联合血清β-HCG、孕酮(P)、雌二醇(E2)、甲胎蛋白(AFP)水平检查在提高异位妊娠诊断中的应用价值。方法选取2018年1月至2019年6月本院收治的异位妊娠患者96例为研究对象,设为实验组,按照检测方法将实验组分为A、B、C 3组,选取同期正常妊娠妇女32名作为对照组(D组),两组受试者均进行血清β-HCG、P、E2、AFP水平检测和B超检查子宫内膜厚度,回顾分析检测数据,比较单项检测与联合检测的诊断符合率。结果两组孕妇血清β-HCG、P、E2、AFP水平及子宫内膜厚度比较差异具有统计学意义(P<0.05),实验组AFP指标高于对照组,β-HCG、P、E2均低于对照组,差异具有统计学意义(P<0.05);血清β-HCG、P、E2、AFP水平及B超检查单个测定的诊断符合率两组中最高的均为B超,达到70%以上,联合检测明显高于单项检测,灵敏度、特异性、Youden指数也均增加,诊断效果更强。结论B超联合血清β-HCG、P、E2、AFP水平测定可以大大提高临床异位妊娠诊断效率,减少漏诊与误诊,简单可行,在临床实际工作中具有较高的价值,值得推广运行。

Objective To evaluate the value of serum beta-hcg,progesterone,estradiol and b-mode ultrasound in the diagnosis of ectopic pregnancy.Methods 96 patients with ectopic pregnancy admitted to our hospital from January 2018 to June 2019 were selected as the research object and set as the experimental group,the group can be divided into three groups according to the diagnostic method namely A,B,C group,32 cases of normal pregnant women were selected for the same period as the control group(group D),two groups of subjects were serum ofβ-HCG,progesterone,estradiol,AFP level testing and ultrasound examination of endometrial thickness,retrospective analysis testing data,compare the diagnostic accordance rate of single detection with joint detection.Results There was significant difference in serum levels ofβ-HCG,progesterone,estradiol,AFP and endometrial thickness between the two groups.Except that the AFP level in the experimental group was higher than that in the control group,all the other levels were lower than that in the control group,which was statistically significant(P<0.05).Serumβ-HCG,progesterone,estradiol,AFP levels and the diagnostic coincidence rate of single b-ultrasound test in both groups were the highest,reaching more than 70%.The combined test was significantly higher than the single test,and the sensitivity,specificity and Youden index were also increased,leading to a stronger diagnostic effect.Conclusionβ-ultrasound combined with serum levels ofβ-HCG,progesterone,estradiol and AFP can greatly improve the diagnostic efficiency of clinical ectopic pregnancy and reduce missed diagnosis and misdiagnosis.It is simple,feasible,and of high value in clinical practice,and is worthy of promotion and operation.