经腹部彩超联合血清性激素检测诊断早期异位妊娠价值

Value of abdominal color ultrasonography combined with serum sex hormone level for diagnosing early ectopic pregnancy

目的:探讨腹部彩超联合血清性激素检测对早期异位妊娠鉴别诊断价值。方法:回顾性收集2019年04月-2022年03月本院收治的异位妊娠患者60例为异位组、正常孕妇60例为对照组临床资料,检测两组血清人绒毛促性腺激素(β-hCG)、黄体生成激素(LH)、血清卵泡生成激素(FSH)、雌二醇(E;)水平,采用腹部彩超检测子宫内膜厚度及子宫附件特征;以最终临床确诊结果为标准,计算腹部彩超联合血清激素水平对早期异位妊娠的鉴别诊断价值。结果:异位组FSH(31.67±7.88 U/L)、LH(27.16±5.92 U/L)水平均高于对照组(10.48±6.39 U/L、9.17±3.14 U/L),β-hCG(1979.4±592.1 IU/L)、E;(206.03±35.24 pg/ml)和子宫内膜厚度(0.85±0.14 cm)低于对照组(2894.1±769.5 IU/L、875.34±110.61 pg/ml、1.17±0.14 cm),附件包块检出率(81.7%)、盆腔积液阳性率(70.0%)检出率均高于对照组(35.0%、38.3%),宫内孕囊检出率(15.0%)低于对照组(100.0%)(P<0.05);超声联合4项激素指标诊断异位妊娠的曲线下面积为0.956,其漏诊率(1.7%)和误诊率(0)均低于各单独指标诊断。结论:腹部彩超联合血清性激素水平检测可大大提高异位妊娠的诊断准确率。

Objective: To explore the value of abdominal color ultrasonography combined with serum sex hormone level for differential diagnosing early ectopic pregnancy. Methods: The clinical data of 60 women with ectopic pregnancy(in group A) and 60 women with normal pregnancy(in group B) during April 2019 to March 2021 were collected retrospectively. The serum levels of β-human chorionic gonadotropin(β-HCG), luteinizing hormone(LH), follicular follicular hormone(FSH), and estradiol(E;) of the women in both groups were detected. The endometrial thickness and uterine adnexal characteristics of the women in both groups were examined by abdominal color ultrasound. The differential diagnosis value of abdominal color Doppler ultrasonography combined with serum hormone level for early ectopic pregnancy was calculated based on the final clinical definite diagnosis results. Results: The levels of FSH(31.67±7.88 U/L) and LH(27.16 ± 5.92 U/L) of the women in group A were significantly higher than those(10.48 ± 6.39 U/L and 9.17±3.14 U/L) of the women in group B. The levels of β-HCG(1979.4 ± 592.1 IU/L) and E;(206.03 ±35.24 pg/ml), and the endometrial thickness(0.85 ± 0.14 cm) of the women in group A were significantly lower than those(2894.1 ± 769.5 IU/L, 875.34±110.61 Pg/mol, and 1.17 ± 0.14 cm) of the women in group B. The detection rate of mass of uterine adnexal(81.7%) and pelvic effusion positive rate(70.0%) of the women in group A were significantly higher than those(35.0% and 38.3%) of the women in group B. The detection rate of intrauterine pregnancy sac(15.0%) of the women in group A was significantly lower than that(100.0%) of the women in group B(P<0.05). The area under the curve of ultrasonography examination combined with four hormone indexes for diagnosing ectopic pregnancy was 0.956, and which missed diagnosis rate(1.7%) and misdiagnosis rate(0) were significantly lower than those of ultrasonography examination or four hormone indexes alone.Conclusion:Abdominal color ultrasonography combined with serum sex hormone detection can greatly improve the diagnostic accuracy of ectopic pregnancy.