通讯作者: 曹丽敏, caolimin1012@hotmail.com

DOI：10.12201/bmr.202408.00036

The value of serological indexes and vaginal color Doppler ultrasound in differential diagnosis of early ectopic pregnancy and threatened abortion

• 摘要：摘要:目的：分析血清学指标人绒毛膜促性腺激素、孕酮、妊娠相关蛋白与阴道彩超对早期异位妊娠和先兆流产的鉴别诊断价值。方法：根据随机抽样法随机选取本院在2022年2月-2024年2月期间收治的早期异位妊娠患者80例作为异位妊娠组，采用倾向性匹配法选取同期80例先兆流产患者为先兆流产组，采用倾向性匹配法选取同期80例正常妊娠孕妇为正常对照组，收集所有纳入对象的年龄、孕周、孕次、血清人绒毛膜促性腺激素、孕酮、妊娠相关蛋白水平、阴道超声阻力指数等资料，采用多因素Logistic回归分析影响早期异位妊娠与先兆流产鉴别的相关因素，然后采用受试者工作特征曲线分析血清人绒毛膜促性腺激素、孕酮、妊娠相关蛋白、阴道超声阻力指数鉴别诊断早期异位妊娠与先兆流产的临床价值。结果：人绒毛膜促性腺激素、孕酮、妊娠相关蛋白水平在正常对照组、先兆流产组、异位妊娠组中依次降低，阴道超声阻力指数依次升高，差异均有统计学意义（P＜0.05）；多因素分析结果显示，血清人绒毛膜促性腺激素、孕酮、妊娠相关蛋白、阴道超声阻力指数是影响早期异位妊娠和先兆流产鉴别的相关因素，差异有统计学意义（P＜0.05）；经受试者工作特征曲线分析，血清人绒毛膜促性腺激素、孕酮、妊娠相关蛋白、阴道超声阻力指数及联合诊断鉴别诊断早期异位妊娠和先兆流产的受试者工作特征曲线下面积（95%CI）分别为0.829（0.765，0.894）、0.986（0.965，1.000）、0.933（0.896，0.969）、0.631（0.545,0.716）、0.999（0.996，1.000）。结论：人绒毛膜促性腺激素、孕酮、妊娠相关蛋白、阴道超声阻力指数对早期异位妊娠和先兆流产均有着较高的鉴别诊断价值，但联合检测的鉴别诊断价值高于单一检测。

  关键词： 早期异位妊娠；先兆流产；孕酮；人绒毛膜促性腺激素；妊娠相关蛋白；阻力指数; ; ; ; ; 

   

  Abstract: Abstract :Objective : To analyze the differential diagnostic value of serological indicators of serum human chorionic gonadotropin, progesterone, pregnancy related proteins and vaginal color Doppler ultrasound in in early ectopic pregnancy and threatened miscarriage.Methods：Based on the random sampling approach, 80 patients with early ectopic pregnancy admitted to our hospital from February 2022 to February 2024 were randomly chosen as the ectopic pregnancy group. Meanwhile, 80 patients with threatened abortion during the same period were selected as the threatened abortion group through the tendency matching method, and 80 pregnant women with normal pregnancies during the same period were also selected as the normal control group by.Data on age, gestational week, gestational frequency, serum human chorionic gonadotropin, progesterone, pregnancy related protein levels, resist index,and other factors affecting the differentiation between early ectopic pregnancy and threatened miscarriage were collected from all enrolled subjects. Logistic regression analysis was used to analyze the relevant factors affecting the differentiation between early ectopic pregnancy and threatened miscarriage. Then, receiver operating curve was used to analyze the clinical value of serum human chorionic gonadotropin, progesterone,pregnancy related protein and resist index in the differential diagnosis of early ectopic pregnancy and threatened miscarriage.Results : The levels of human chorionic gonadotropin, progesterone and pregnancy-related protein in the normal control group, threatened abortion group and ectopic pregnancy group decreased in turn, and the resistance index increased in turn, the differences were statistically significant ( P < 0.05 ).; The results of multivariate analysis showed that serum human chorionic gonadotropin, progesterone,pregnancy related proteins and resist indexwere the relevant factors affecting the differentiation between early ectopic pregnancy and threatened miscarriage, and the difference was statistically significant (P<0.05); According to receiver operating curve analysis, the area under the curve of receiver operating characteristic (95% CI) of serum human chorionic gonadotropin, progesterone, pregnancy related proteins, resistance index and combined diagnosis in the differential diagnosis of early ectopic pregnancy and threatened miscarriage were 0.829 (0.765, 0.894), 0.986 (0.965, 1.000), 0.933 (0.896, 0.969),0.631（0.545,0.716），0.999 (0.996,1.000 ), respectively.Conclusion :Human chorionic gonadotropin, progesterone, pregnancy-associated protein and resistance index have high differential diagnostic value for early ectopic pregnancy and threatened abortion, but the differential diagnostic value of combined detection is higher than that of single detection.

  Key words: Early ectopic pregnancy; Threatened miscarriage; Progesterone; Human chorionic gonadotropin; Pregnancy related proteins; Resist index

  提交时间：2024-08-20

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• 序号	提交日期	编号	操作
  1	2024-06-18	bmr.202408.00036V1	下载

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