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彩色多普勒超声联合血清肿瘤抗原125 、甲胎蛋白检测对胎盘早剥的早期诊断价值

Clinical value of color doppler ultrasonography combined with CA125 and AFP in the early diagnosis of placental abruption

摘要:

目的 探讨彩色多普勒超声联合血清中肿瘤抗原125(CA125)、甲胎蛋白( AFP)检测对胎盘早剥的早期诊断价值.方法 选取2015年1月至2017年12月舟山市妇幼保健院诊治的胎盘早剥患者120例作为观察组,正常妊娠分娩产妇120例为对照组,两组均进行彩色多普勒超声检查,同时检测其外周血清中CA125、AFP水平,并在分娩后检查胎盘表面是否附着陈旧血块或血块压迹,对胎盘早剥的程度进行分类,比较不同检测方法对胎盘早剥检出率,并对胎盘早剥发生程度与血清CA125、AFP水的相关性进行统计学分析.结果 胎盘早剥组孕妇血清中 CA125 和 AFP 水平较对照组明显升高,胎盘早剥Ⅲ度 CA125 和 AFP 水平[(69.1 ± 8.9)U/mL、(279.8 ± 41.3) μg/L]均明显高于Ⅱ度[(61.6 ± 9.4) U/mL、(234.9 ± 46.2) μg/L]和Ⅰ度[(52.2 ± 8.9)U/mL、(205.7 ± 43.1)μg/L]的水平,差异均有统计学意义(均P<0.01).单一彩色多普勒超声检查对胎盘早剥检出率仅为46.7% ;超声联合血清CA125水平检测对胎盘早剥检出率为81.7% ;超声联合血清AFP水平检测对胎盘早剥检出率为78.3% ;超声检查联合血清CA125、AFP水平检查对胎盘早剥检出率为90.8% ;三种联合检测方案对胎盘早剥的检出率明显高于彩色多普勒超声检查(χ2 =11.67,P <0.01),其中彩色多普勒超声联合血清CA125、AFP水平检查对胎盘早剥检出率较其余两组更高( χ2 =12.56、12.64,均P<0.01).结论 血清CA125、AFP水平与胎盘早剥的发生及严重程度有关,彩色多普勒超声检查联合血清CA125、AFP检测可明显提高胎盘早剥的检出率,孕妇血清中CA125、AFP的检测值可以作为胎盘早剥早期诊断的指标之一.

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abstracts:

Objective To explore the clinical value of color doppler ultrasonography combined with CA125 and AFP in the early diagnosis of placental abruption.Methods From January 2015 to December 2017,120 patients with placental abruption in the Maternal and Child Health Hospital of Zhoushan were selected as observation group. 120 healthy pregnant individuals were selected as control group.They all received the color Doppler ultrasound and detection of serum CA125 and AFP levels.The clots checking on the surface of placenta post-delivery was conducted at the same time. The statistical analysis was set up to compare two groups according to those tests from the lab reports.Results The levels of serum CA125 and AFP were higher in the observation group compared with those in the control group.In details,the CA125[(69.1 ± 8.9) U/mL] and AFP[(279.8 ± 41.3) μg/L] levels in placental abruption grade Ⅲ were significantly higher than those in gradeⅡ[ CA125 ( 61.6 ± 9.4 ) U/mL, AFP ( 234.9 ± 46.2)μg/L] and gradeⅠ[ CA125 (52.2 ± 8.9) U/mL,AFP(205.7 ± 43.1) μg/L] ( all P<0.01).The positive predictive values of placental abruption by the color Doppler ultrasound alone was 46.7%.The combination of the color Doppler ultrasound with serum CA125 was 81.7%.The combination of the color Doppler ultrasound with serum AFP was 78.3%.The combination of those three tests was increased up to 90.8% ,which was the best pre-diagnosis compared to the color Doppler ultrasound alone and the other two combinations(χ2 =11.67,P<0.01).The detective rate of combination of the color Doppler ultrasound with serum CA125 and AFP was higher than the other two combi-nations(χ2 =12. 56, 12. 64, all P <0. 01 ). Conclusion The levels of serum CA125 and AFP are positively correlated with placental abruption.The combination tests using the color Doppler ultrasound and both serum CA125 and AFP is a novel and sensitive method as to pre-diagnose high risk placental abruption during pregnancy.

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作者: 陈建国 [1] 芦金飞 [1] 陈文艳 [1] 陈萍 [2]
期刊: 《中国基层医药》2019年26卷12期 1467-1471页 ISTIC
栏目名称: 论著
DOI: 10.3760/cma.j.issn.1008-6706.2019.12.014
发布时间: 2019-07-25
基金项目:
浙江省舟山市医药卫生科技计划项目(2014A05) Fund program: Medical and Health Science and Technology Planning Project of Zhoushan City, Zhejiang Province
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