• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2017, Vol. 19 ›› Issue (4): 375-379.DOI: 10.3969/j.issn.1671-2587.2017.04.019

• 临床检验 • 上一篇    下一篇

联合检测血清血管内皮生长因子和β-HCG对早期异位妊娠的诊断意义*

徐进, 沈杨   

  1. 210012 南京市雨花医院妇产科（徐进）,东南大学附属中大医院妇产科（沈杨）
  • 收稿日期:2017-03-02 出版日期:2017-08-20 发布日期:2017-08-09
  • 作者简介:（1978-）,女,江苏南京人,主治医师,硕士,主要从事妇科的基础与临床研究,（E-mail）xujin-lu@163.com。
  • 基金资助:
    *本课题受江苏省卫生厅青年基金项目（No; Q201305）资助

The Diagnose Value of Combining Determination Vascular Endothelial Growth Factor and β-HCG in Early Non-typical Ectopic Pregnancy

XU Jin, Shen Yang   

  1. Nanjing Yuhua hospital,Nanjng 210012
  • Received:2017-03-02 Online:2017-08-20 Published:2017-08-09

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摘要： 目的 探讨联合检测血清血管内皮生长因子（VEGF）和β-HCG对早期异位妊娠的鉴别诊断价值。方法 收集南京市雨花医院140例妊娠患者,其中异位妊娠60例（孕周<7周）作为异位妊娠组,选择同期正常宫内妊娠80例为正常妊娠组。采用ELISA法对两组血清VEGF和β-HCG水平进行测定,根据受试者工作曲线（ROC）计算临床诊断界值,并对结果进行统计分析。结果 异位妊娠组中VEGF表达显著高于正常妊娠组,β-HCG表达低于正常妊娠组,差异均有统计学意义（VEGF pg/ml：270.35±111.55 vs. 125.94±42.38,P<0.001;β-HCG U/ml：9 790.35±1620.79 vs. 12 888.13±2 544.4,P<0.001）。VEGF取202.50pg/ml时,AUC值为0.945,诊断异位妊娠的敏感度、特异度和准确性分别为75.0%、97.5%、90.2%。β-HCG取10 950.30U/ml时,AUC值为0.855,诊断异位妊娠的敏感度、特异度和准确性分别为76.3%、76.7%、83.1. %。二者联合检测的敏感度、特异度和准确性为91.3%、95.0%和85.5%。结论 早期异位妊娠时,血清中VEGF显著增高、β-HCG下降,二者对异位妊娠有一定的诊断价值。联合检测VEGF和β-HCG可进一步提高早期异位妊娠诊断敏感度。

关键词: 异位妊娠, 血管内皮生长因子, β-HCG, 诊断

Abstract: Objective To determine the level of VEGF and β-HCG in early non-typical ectopic pregnancy （EP） and investigate the combining determination of diagnostic value of VEGF andβ-HCG for EP. Methods 140 pregnancy patients from Nanjing Yuhua hospital were enrolled into this study,of which 60 patients with EP （<7-week）and 80 patients with intrauterinepregnancy. The VEGF andβ-HCG levels were tested by ELISA,ROC was used to cut-off value and all the Results were analyzed by the statistical method. Results The levels of VEGF in EP was significantly higher than that in intrauterinepregnancy,while β-HCG was significantly lower than that in intrauterinepregnancy（VEGF：270.35±111.55pg/ml vs. 125.94±42.38 pg/ml,P=0.000;β-HCG：9 790.35±1 620.79 vs. 12888.13±2 544.41U/ml,P =0.000）. With a cut-off value of 202.50 pg/ml,the AUC value of VEGF is 0.945. The sensitivity of VEGF testing for diagnosing EP was 75.0%,the specificity was 97.5% and the accuracy was 90.2%.With a cut-off value of 10 950.30 U/ml,the AUC value of VEGF is 0.855. The sensitivity of β-HCG testing for diagnosing EP was 76.3%,the specificity was 76.7%,and the accuracy was 83.1%. The sensitivity of the combined testing was 91.3%,the specificity was 95.0% and the overall accuracy was 85.5%. The sensitivity and the overall accuracy of combined testing were higher than those of β-HCG and ADAM12-S testing single. Conclusion EP presents higher VEGF and lower β-HCG concentration than those with intrauterinepregnancy and determination of VEGF and β-HCG is useful to differentiate EP from intrauterinepregnancy. The combined testing of VEGF and β-HCG can increase the sensitivity of diagnosis of EP.

Key words: Ectopic pregnancy, Vascular endothelial growth factor, β-HCG, Diagnosis

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