超声联合血清学指标在胎盘植入诊断中的应用价值分析

Value analysis of ultrasonography combined with serological indexes in diagnosis of placenta implantation

目的 分析超声联合血清学指标在胎盘植入诊断中的应用价值。方法 选取2020年1月到2022年2月在安阳市第六人民医院分娩的190例可疑胎盘植入孕妇作为研究对象,以病理诊断结果为金标准,将孕妇分为A组(n=85)和B组(n=105),A组为胎盘植入组,B组为非胎盘植入组。分析彩色多普勒超声检查和临床病理检查结果的符合率,比较两组患者的血清指标学水平,绘制受试者工作特征(ROC)曲线,分析各指标对胎盘植入的诊断效能。结果 彩色多普勒超声对胎盘植入的诊断符合率为72.63%(138/190);A组血清绒毛膜促性腺激素(HCG)和血管内皮生长因子(VEGF)水平明显高于B组,血清可溶性血管内皮生长因子受体-1(sFlt-1)水平明显低于B组,差异有统计学意义(P<0.05);经ROC曲线分析可见,彩色多普勒超声、HCG、VEGF、sFlt-1以及联合检测对产前胎盘植入诊断的曲线下面积分别为0.719、0.865、0.864、0.897和0.978,联合检测价值优于单项检测。结论 超声联合血清学指标对产前胎盘植入的诊断效能优于单项检测,具有重要的临床价值。

Objective To analyze the value of ultrasonography combined with serological indexes in the diagnosis of placenta implantation.Methods Totally 190 pregnant women with suspected placental implantation who delivered in Anyang City Sixth People's Hospital from Jan.2020 to Feb.2022 were selected as the study objects.According to the pathological diagnosis results as the gold standard,pregnant women were divided into group A(n=85)and group B(n=105).Group A was placental implantation group,and group B was non-placental implantation group.The coincidence rate of color Doppler ultrasound and clinicopathological examination results was analyzed.The serum levels of patients in the two groups were compared,and receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic efficacy of each indicator for placenta implantation.Results The coincidence rate of color Doppler ultrasound in placenta implantation was 72.63%(138/190).The levels of serum chorionic gonadotropin(HCG)and vascular endothelial growth factor(VECF)in group A were substantially higher than those of group B,and the levels of serum soluble vascular endothelial growth factor receptor-1(sFlt-1)were substantially lower than those of group B,the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under curve of color Doppler ultrasound,HCG,VECF,sFlt-1 and combined detection for prenatal placenta implantation were O.719,0.865,0.864,0.897 and 0.978,respectively,indicating that combined detection was better than single detection.Conclusion Ultrasound combined with serological indicators is more effective than single detection in the diagnosis of prenatal placenta implantation,and has important clinical value.