宫颈组织剪切波弹性成像技术结合人绒毛膜促性腺激素β亚基检测对高龄孕妇流产风险的评估价值

The value of cervical tissue shear wave elastography combined with human chorionic gonadotropinβsubunit detection in the assessment of abortion risk in elderly pregnant women

目的探究宫颈组织剪切波弹性成像(SWE)技术结合人绒毛膜促性腺激素β亚基(β-HCG)检测对高龄孕妇流产风险的评估价值。方法选取2019年2月至2021年12月天水市第一人民医院收治的80名高龄伴流产风险孕妇作为研究组,另选取同期于本院进行产检的85名高龄健康孕妇作为对照组。所有研究对象均进行宫颈组织SWE检查和血清β-HCG表达水平测定,比较两组宫颈组织SWE参数杨氏模量值和血清β-HCG表达水平,采用ROC曲线分析杨氏模量值和β-HCG表达水平在评估高龄孕妇流产风险中的应用价值。结果研究组宫颈长度(CL)短于对照组,宫颈内口应变率(IS)明显高于对照组,差异有统计学意义(P<0.05);两组宫颈应变率(CS)、宫颈外口应变率(ES)比较差异无统计学意义。研究组宫颈组织内口、外口的杨氏模量值均低于对照组,差异有统计学意义(P<0.05)。研究组血清β-HCG水平为(5742.65±229.71)mIU/ml,低于对照组的(10332.47±413.28)mIU/ml,差异有统计学意义(P<0.05)。ROC曲线结果显示,宫颈组织内口、外口杨氏模量值、血清β-HCG及三者联合评估高龄孕妇流产风险的曲线下面积分别为0.739、0.731、0.782、0.874(P<0.05)。结论宫颈组织杨氏模量值与血清β-HCG水平在高龄伴流产风险孕妇中均呈显著低水平,二者联合检查能有效评估高龄孕妇的流产风险,临床具有较高应用价值。

Objective To evaluate the value of cervical tissue shear wave elastography(SWE)combined with human chorionic gonadotropinβsubunit(β-HCG)detection in the assessment of abortion risk in elderly pregnant women.Methods 80 elderly pregnant women with abortion risk who were admitted to the Tianshui First People's Hospital from February 2019 to December 2021 were selected as the study group,and 85 healthy elderly pregnant women who underwent prenatal examination in the hospital during the same period were selected as the control group.All subjects underwent cervical tissue SWE examination and serumβ-HCG expression level,Young's modulus of cervical tissue SWE parameter and serumβ-HCG expression level were compared between the two groups.ROC curve was used to analyze the application value of Young's modulus andβ-HCG expression level in assessing the risk of abortion in elderly pregnant women.Results The cervical length(CL)in the study group was shorter than that in the control group,and the cervical internal cervical mouth strain rate(IS)was higher than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in cervical strain rate(CS)and external cervical mouth strain rate(ES)between the two groups.The Young's modulus of the cervical tissue in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The serumβ-HCG level in the study group was(5742.65±229.71)mIU/ml,which was lower than(10332.47±413.28)mIU/ml in the control group,and the difference was statistically significant(P<0.05).The results of ROC curve showed that the area under the curve of inner and outer mouth of cervical tissue,serumβ-HCG and their combined assessment of abortion risk in elderly pregnant women were 0.739,0.731,0.782 and 0.874,respectively(P<0.05).Conclusion Young's modulus of cervical tissue and serumβ-HCG levels are significantly low in elderly pregnant women with abortion rish,the combined examination of the two can effectively assess the risk of abortion in elderly pregnant women,and has high clinical application value.