彩色多普勒超声联合血清miR-139-3p水平检测在凶险性前置胎盘合并胎盘植入诊断中的应用价值

The Value of Color Doppler Ultrasound Combined with Serum MiR-139-3pLevels in the Diagnosis of Dangerous Placenta Previa

目的探讨彩色多普勒超声(彩超)联合血清miR-139-3p水平检测在凶险性前置胎盘(PPP)合并胎盘植入诊断中的应用价值。方法前瞻性选取2022年1月至12月入同济大学附属第一妇婴保健院产科接受剖宫产手术的PPP患者65例作为研究对象,其中胎盘非植入患者为38例(胎盘非植入组),PPP伴胎盘植入患者为27例(胎盘植入组)。PPP伴胎盘植入者中,中央型为13例,部分型为8例,边缘型为6例。同时收集同院产科行剖宫产手术的无妊娠合并症、无胎盘前置的孕妇60例作为对照组。所有研究对象均行彩超检查及血清miR-139-3p检查,采用四格表法分析彩超诊断PPP合并胎盘植入的价值;采用受试者工作特征曲线(ROC)分析彩超联合血清miR-139-3p水平对PPP合并胎盘植入的诊断效能。结果与对照组相比,胎盘非植入组和胎盘植入组中miR-139-3p水平明显降低(P<0.05);与胎盘非植入组相比,胎盘植入组中miR-139-3p水平显著降低(P<0.05);中央型患者血清中miR-139-3p水平明显低于部分型和边缘型(P<0.05),部分型患者血清中miR-139-3p水平明显低于边缘型(P<0.05);彩超联合血清miR-139-3p水平检测诊断PPP的曲线下面积、灵敏度、阳性预测值及阴性预测值均高于彩色超声以及miR-139-3p单独诊断,差异有统计学意义(P<0.05)。结论PPP合并胎盘植入患者血清中miR-139-3p表达水平降低,彩超联合血清中miR-139-3p表达水平检测在PPP合并胎盘植入中具有一定的诊断效能。

Objective To explore the value of color Doppler ultrasound(CDUS)combined with serum miR-139-3p level in the diagnosis of dangerous Placenta praevia(PPP)with placenta accreta.Methods We prospectively selected 65 PPP patients admitted to the First Maternal and Infant Health Hospital affiliated to Tongji University from January,to December,2022 to undergo Caesarean section,and 27 patients with PPP and placenta implantation(placenta implantation group).Among PPP patients with placental implantation,there were 13 cases of central type,8 cases of partial type,and 6 cases of marginal type.60 patients without pregnancy complications and placenta previa who underwent cesarean section in our hospital were collected as a control group from the same duration.All subjects underwent Doppler color ultrasound and serum miR-139-3p examinations.The value of Doppler color ultrasound in the diagnosis of PPP with placental implantation was analyzed using a four-grid table method;The diagnostic efficacy of Doppler color ultrasound combined with serum miR-139-3p levels in the diagnosis of PPP with placental implantation was analyzed using receiver operating characteristic curve(ROC).Results Compared with the control group,the levels of miR-139-3p in the placenta non-implantation group and the placenta implantation group were significantly lower(P<0.05);Compared with the non-implantation group,the level of miR-139-3p in the placenta implantation group was significantly lower(P<0.05);The serum miR-139-3p level in patients with central type was significantly lower than that in patients with partial type and marginal type(P<0.05).The serum miR-139-3p level in patients with partial type was significantly lower than that in patients with marginal type(P<0.05).The AUC value,sensitivity,positive predictive value,and negative predictive value of color ultrasound combined with miR-139-3p were significantly higher than those of color ultrasound and miR-139-3p individually(P<0.05).Conclusion The expression level of miR-139-3p in the serum of patients with PPP combined with placental implantation decreases.The combination of color Doppler ultrasound and detection of miR-139-3p expression level in serum has certain diagnostic efficacy in PPP combined with placental implantation.