血清中孕酮水平在早期异位妊娠中的诊断价值(1)

http://www.100md.com 2011年11月15日 王玲

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     [摘要] 目的 探讨血清孕酮(progesterone)水平在早期异位妊娠(ectopic pregnancy，EP)诊断中的价值。方法 前瞻性分析我科2006年7月～2011年1月确诊的早期异位妊娠的患者66例，同期宫内早孕患者121例。运用化学发光法检测异位妊娠和宫内早孕患者外周血孕酮的水平，比较两组孕酮水平的差异，计算孕酮诊断异位妊娠的敏感性和特异性，绘制受试者工作曲线(ROC)对诊断试验进行评价。结果 异位妊娠组血清孕酮含量中位数为28.3nmol/L，宫内早孕组为66.2nmol/L，数据为偏态分布资料，经Wilcoxon秩和检验，两组差别有统计学意义(P<0.05)；以36nmol/L为诊断异位妊娠的Cut-off值，诊断试验的敏感性和特异性分别为77.71%和68.49%，ROC曲线下面积(AUC)为0.84。结论 血清孕酮检测可作为临床异位妊娠诊断的参考指标。

    [关键词] 孕酮；异位妊娠；诊断

    [中图分类号] R714.2 [文献标识码] B [文章编号] 1673-9701(2011)32-88-03

    Diagnosis Value of Progesterone in Serum for Ectopic Pregnancy

    WANG Ling

    Department of Gynecology and Obstetrics，Red Cross Hospital of Yuhuan County in Zhejiang Province， Yuhuan 317602，China

    [Abstract] Objective To evaluate the diagnostic value of the peripheral blood progesterone in ectopic pregnancy.Methods Prospectively included 66 ectopic pregnancy and 121 intrauterine gestation women in our hospital from July 2006 to January 2011.Peripheral blood progesterone level of 187 pregnancy women were tested by enzyme linked immunosorbent chemiluminescence assay.The peripheral blood progesterone level of the two groups was compared. And ROC curve was used to analyse the diagnosis effect of progesterone. Results The median peripheral blood progesterone level of the ectopic pregnancy and intrauterine gestation were 28.3nmol/L and 66.2nmol/L respectively.Singificant differences of peripheral blood level progesterone was detected between the two groups(P<0.05).At the threshold of 36nmol/L， sensitivity and specificity of progesterone as a serologic marker were 77.71% and 68.49% respectively. The under-curve area (AUC) of progesterone was 0.84. Conclusion As a serologic marker progesterone could be used as reference for the diagnosis of ectopic pregnancy

    [Key words] Progesterone； Ectopic pregnancy； Diagnosis

    异位妊娠是妇科常见病、多发病，也是妇科急腹症之一，一旦发生破裂，将发生腹腔内大出血、休克，严重者甚至危及孕妇的生命，因此早期准确地做出诊断是关键[1]。近年来，异位妊娠的发生率有逐年增高的趋势[2]。单纯从影像学对早期异位妊娠做出确切的诊断还存在一定的困难，目前大多通过影像学技术与一些生化检测指标相结合的方法作出诊断。我们前瞻性地对66例早期异位妊娠患者和121例宫内早孕患者进行了血清孕酮检测分析，评价血清孕酮作为早期诊断异位妊娠标志物的临床价值。

    1 资料与方法

    1.1 一般资料

    前瞻性分析我科2006年7月～2011年1月确诊的早期异位妊娠患者66例，同期宫内早孕患者121例，采用化学发光法检测宫内早孕和异位妊娠患者外周血中孕酮的水平 ......

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