黄体血流对流产型异位妊娠的预测价值

The value of corpus luteum blood flow analysis for predicting abortive ectopic pregnancy

目的:探讨黄体血流对流产型异位妊娠的预测价值。方法:选择2015年4月—2018年1月本院确诊的异位妊娠患者,根据妊娠情况分为胚胎存活性异位妊娠67例、流产型异位妊娠39例,选择同期宫内孕且胚胎存活产妇70例为对照组。所有孕妇超声检测,记录动脉血流阻力指数(RI)、收缩期峰值流速(SPV)及黄体血流形态。ROC分析RI和SPV预测流产型异位妊娠价值。结果:超声下对照组均检出黄体,可见半环状和环状血流信号;胚胎存活型异位妊娠组可见半环状和环状血流信号;流产型异位妊娠组黄体形态欠饱满,周边多为无明显血流。对照组和胚胎存活性异位妊娠组卵巢黄体血流分布及RI和SPV无差异(P>0.05),流产型异位妊娠组的点状、半环状、环状及无明显血流分布与上述两组存在差异,且RI明显降低,SPV明显增高(均P<0.05);预测流产型异位妊娠RI的AUC、cut-off值、敏感性和特异性分别为0.931、0.65、86.9%和94.2%,SPV分别为0.911cm/s、32.19、82.1%和90.7%。结论:黄体血流参数RI和SPV对预测流产型异位妊娠有一定临床价值。

Objective:To investigate the value of corpus luteum blood flow analysis for predicting abortive ectopic pregnancy.Methods:From April 2015 to January 2018,137 women with ectopic pregnancy were divided into 2 groups according to the pregnancy status,which included in group A(39 women with the abortive ectopic pregnancy)and group B(67 women with the embryo viable ectopic pregnancy),and another 70 health pregnant women were in group C.The artery resistance index(RI),systolic peak flow velocity(SPV),and the luteal pattern of flow of all women by ultrasound detection were recorded and compared among the three groups.ROC was used to analyze the value of RI and SPV for predicting abortive ectopic pregnancy.Results:The semicircular and annular blood flow signals of women were found in group C,the semi-annular and annular blood flow signals of women were observed in group B,but the corpus luteum of women were not observed clearly and the blood flow in the periphery of women were not obvious in group A.There were no significant difference in ovarian corpus luteum flow distribution and values of RI and SPV of women between group B and group C(P>0.05).The rate of distribution of spot and semicircular,and no obvious blood flow of women in group A was significant different from those of women in group B and group C(P<0.05),the value RI was significant lower and the value of SPV was significant higher(P<0.05).As for predicting abortive ectopic pregnancy,the AUC,cut-off value,sensitivity and specificity of RI value were 0.931,0.65,86.9%,and 94.2%,respectively,and those of SPV value were 0.911 cms-1,32.19,82.1%,and 90.7%,respectively.Conclusion:The RI and SPV as corpus luteum blood flow parameters for predicting abortive ectopic pregnancy has some clinical value.