超声评分法联合人绒毛膜促性腺激素β、甲胎蛋白、肌酸激酶对凶险型前置胎盘合并胎盘植入的诊断效能

The diagnostic efficacy of ultrasound scoring method,combined with human chorionic gonadotropin β,alpha-fetoprotein,and creatine kinase on dangerous placenta previa combined with placenta implantation

目的探索超声评分法联合人绒毛膜促性腺激素β(human chorionic gonadotropinβ,β-hCG)、甲胎蛋白(alpha fetoprotein,AFP)、肌酸激酶(creatine kinase,CK)对凶险型前置胎盘(pernicious placenta previa,PPP)合并胎盘植入的诊断效能。方法选择PPP患者130例设为观察组,健康正常分娩产妇128例设为对照组,观察组根据是否存在胎盘植入分为存在胎盘植入型组(植入组,n=97)和非胎盘植入型组(非植入组,n=33)。比较各组超声评分法和血清β-hCG、AFP、CK水平;Spearman法分析超声评分法和血清β-hCG、AFP、CK水平与PPP合并胎盘植入的相关性;ROC曲线分析超声评分法、β-hCG、AFP、CK水平对PPP合并胎盘植入的诊断效能。结果观察组超声评分法、β-hCG、AFP、CK水平均高于对照组(P<0.05);植入组超声评分法、β-hCG、AFP、CK均高于非植入组(P<0.05)。Spearman法分析结果显示,超声评分法、β-hCG、AFP、CK与PPP合并胎盘植入均呈正相关(r=0.566、0.537、0.439、0.524;P<0.05)。ROC曲线分析结果显示,超声评分法、β-hCG、AFP、CK及四项联合诊断的AUC分别为0.816、0.877、0.866、0.758、0.956,四项联合诊断对PPP合并胎盘植入诊断效能优于单项检验。结论超声评分法联合血清β-hCG、AFP、CK对PPP合并胎盘植入的诊断效能较高。

Objective To explore the diagnostic efficacy of ultrasound scoring method combined with human chorionic gonadotropinβ(β-hCG),alpha fetoprotein(AFP),and creatine kinase(CK)on pernicious placenta previa(PPP)combined with placental implantation.Methods A total of 130 PPP patients were enrolled as the observation group,and 128 healthy parturients as control group.The observation group was divided into two groups according to presence of placental implantation,namely,implantation group(with placental implantation,n=97)and non-implantation group(without placental implantation,n=33).The ultrasound scoring method and the serumβ-hCG,AFP,and CK levels were compared in each group.Spearman analysis was used to analyze the correlation of ultrasound scoring method and serumβ-hCG,AFP,and CK with PPP and placental implantation.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of ultrasound scoring method,β-hCG,AFP,and PK levels for PPP with placental implantation.Results The ultrasound score method,β-hCG,AFP,and CK levels were higher in the observation group than in the control group(P<0.05).The ultrasound score method,β-hCG,AFP,and CK in the implantation group were all higher than those in the non-implantion group(P<0.05).The results of Spearman analysis showed that ultrasound scoring,β-hCG,AFP,and CK were positively correlated with PPP and placental implantation(r=0.566,0.537,0.439 and 0.524;P<0.05).The results of ROC curve analysis showed that the area under the ROC curve(AUC)of ultrasound scoring method,β-hCG,AFP,CK and the combined diagnoses of the four indicators were 0.816,0.877,0.866,0.758 and 0.956,respectively,and the diagnostic efficacy of the combined diagnosis of the four indicators for PPP with placental implantation was better than the single detection.Conclusion The combination of ultrasound scoring method with serumβ-hCG,AFP,and CK has high diagnostic efficacy for PPP with placental implantation.