阴道超声测囊芽差联合血清hCG、E_(2)、P、CA125水平对早期先兆流产的诊断价值

Diagnostic Value of Negative Ultrasound Cyst Bud Difference and Serum hCG,E2,P,and CA125 Levels for Early Threatened Miscarriage

目的:探讨阴道超声测囊芽差联合血清人绒毛膜促性腺激素(hCG)、雌二醇(E_(2))、孕酮(P)、糖类抗原125(CA125)水平对早期先兆流产(ETA)的诊断价值。方法:选取2023年2月-2024年2月北海市第二人民医院收治的63例ETA患者作为ETA组,另选取同期接受产检的45例正常孕妇作为正常妊娠组,均接受经阴道彩色多普勒超声检查和血清hCG、E_(2)、P、CA125检测,比较两组囊芽差、血清指标水平,进行单因素与多因素logistic回归分析,采用受试者工作特征(ROC)曲线评估诊断价值。结果:ETA组囊芽差异常率较正常妊娠组高,差异有统计学意义(P<0.05);ETA组hCG、E_(2)、P较正常妊娠组更低,CA125更高,孕囊差更大,差异有统计学意义(P<0.05);多因素logistic回归分析结果显示,孕囊差(OR=1.885)、CA125(OR=1.893)是影响ETA发生的独立危险因素(P<0.05),hCG(OR=0.713)、E_(2)(OR=0.629)、P(OR=0.675)是保护因素(P<0.05);绘制ROC曲线显示,囊芽差、hCG、E_(2)、P、CA125、5项联合诊断ETA的曲线下面积(AUC)分别为0.765、0.737、0.670、0.628、0.592、0.881(P<0.05)。结论:囊芽差、hCG、E_(2)、P、CA125均可用于诊断ETA,阴道超声测囊芽差异常对诊断ETA有重要意义,联合诊断价值更高,可为后续治疗提供可靠依据,提高妊娠成功率。

Objective:To explore the diagnostic value of negative ultrasound cyst bud difference and serum levels of human chorionic gonadotropin(hCG),estradiol(E_(2)),progesterone(P),and carbohydrate antigen 125(CA125)in early threatened miscarriage(ETA).Method:A total of 63 ETA patients from March 2023 to February 2024 who were admitted in the Second People's Hospital of Beihai were selected as the ETA group,and 45 normal pregnant women who were underwent prenatal check up during the same period were selected as the normal pregnancy group.All subjects were underwent transvaginal color Doppler ultrasound examination and serum hCG,E_(2),P,and CA125 detection.The differences in cyst bud difference and serum indicator levels in both groups were compared,and univariate and multivariate logistic regression analyses were performed.The diagnostic value was evaluated by receiver operating characteristic(ROC)curves.Result:In comparision of the normal pregnancy group,the abnormal rate of cyst bud difference in the ETA group was higher,and the difference was statistically significant(P<0.05).In comparision of the normal pregnancy group,cyst bud difference,hCG,E_(2),and P levels in the ETA group were lower,and CA125 levels were higher,cyst bud difference was larger,the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that cyst bud difference(OR=1.885),and CA125(OR=1.893)were independent risk factors affecting the occurrence of ETA(P<0.05),hCG(OR=0.713),E_(2)(OR=0.629),P(OR=0.675)were protective factors(P<0.05).The ROC curve was plotted,and the area under the curve(AUC)for ETA,including cyst bud difference,hCG,E_(2),P,CA125,and 5 indicators combined diagnosis were 0.765,0.737,0.670,0.628,0.592,and 0.881,respectively(P<0.05).Conclusion:Cyst bud difference,hCG,E_(2),P,and CA125 can all be used to predict ETA.Abnormal cyst bud difference detected by negative ultrasound is of great significance for diagnosing ETA,and the combined diagnostic value is higher.It can provide reliable basis for subsequent treatment and improve pregnancy success rate.