海南医科大学学报

目的:探讨血清β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、癌抗原125(CA125)联合彩色多普勒超声对异位妊娠(EP)早期诊断的临床价值。方法:选取河北钢铁集团宣钢职工医院2014年9月~2015年9月收治的50例EP患者为观察组,选取50例正常孕妇作为对照组;两组于就诊当天抽取空腹肘静脉血5mL,离心取血清,采用化学发光免疫法测定血清β-HCG、P、CA125水平,于48h后再次测定β-HCG水平;阴道彩色多普勒超声诊断仪检测卵巢黄体血流动力学阻力指数(RI)、收缩期峰值流速(PSV)的变化,观察黄体血供分布情况。结果:观察组血清β-HCG、P、CA125水平均低于对照组,两组比较有统计学意义(P<0.05);β-HCG<2 000IU/L时,48h血β-HCG观察组有3例(6.0%)呈现倍增现象,对照组有49例(98.0%)呈现倍增现象,两组比较差异有统计学意义(P<0.05);观察组RI高于对照组,PSV低于对照组,差异有统计学意义(P<0.05);观察组血供以半环状为主,占58.0%,对照组以环状为主,占70.0%,两组差异有统计学意义(P<0.05)。结论:测定孕妇血清β-HCG、P、CA125水平,联合阴道彩色多普勒超声检测卵巢黄体RI、PSV情况,有助于鉴别正常宫内妊娠及EP,防止误诊漏诊,为EP的早期诊断与及时治疗提供准确参考价值,可作为EP诊断较理想的方法。

Objective:To explore the clinical value of serumβ-human chorionic gonadotropin(β-HCG),progesterone(P),Cancer antigen125(CA125),in combination with color Doppler ultrasound in the early diagnosis of ectopic pregnancy(EP).Methods:A total of 50 patients with EP who were admitted to our hospital from September,2014 to September,2015 were included in the study and served as the observation group,while 50 normal pregnant women were served as the control group.A volume of 5mL of fasting elbow venous blood in both groups was extracted in the day on admission,and then was centrifuged for serum.The chemiluminescence immunoassay was used to detect the levels of serumβ-HCG,P,and CA125.After 48 h,β-HCG level was detected again.The vaginal color Doppler diasonograph was used to detect the changes of resistance index(RI)and peak systolic velocity(PSV)of corpus luteum.The blood supply of corpus luteum was observed.Results:The levels of serumβ-HCG,P,and CA125 in the observation group were significantly lower than those in the control group(P<0.05),with statistically significant differences.Whenβ-HCG<2 000IU/L,after 48 h,serumβ-HCG level was doubled in3cases(6.0%)in the observation group,while 49cases(98.0%)in the control group,with statistically significant differences(P<0.05).RI in the observation group was significantly higher than that in the control group,while PSV was significantly lower than that in the control group,with statistically significant differences(P<0.05).Blood supply in the observation group was in a half ring shape,accounting for 58.0%,while in the control group was in a ring shape,accounting for 70.0%,and the comparison was statistically significant(P<0.05).Conclusions:Determination of the levels of serumβ-HCG,P,and CA125 in the pregnant women,in combination with the detection of RI and PSV of corpus luteum by vaginal color Doppler ultrasound,can contribute to distinguish the normal intrauterine pregnancy and EP and prevent the misdiagnosis,which can provide an accurate reference value for the early diagnosis and timely treatment of EP,and can be served as an ideal method for the diagnosis of EP.