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目的 探讨子宫内膜厚度是否对诊断异位妊娠有预测价值。方法 2 0 0 0年 6月至 2 0 0 3年 8月上海市浦东新区妇幼保健院采用阴式B超对 16 4例异位妊娠疑似病例的子宫内膜进行测定 ,将随访结果与子宫内膜厚度、孕龄及血 β HCG水平进行比较。 结果 14 7例资料完整 ,其中 5 9例 (4 0 % )确诊为异位妊娠 ,4 6例 (31% )为自然流产 ,4 2例 (2 9% )为宫内孕。异位妊娠、自然流产及正常宫内孕内膜厚分别为 (8 2 4± 1 4 3)mm、(8 96±0 89)mm、(12 4 9± 1 6 5 )mm ,异位妊娠、自然流产分别与正常宫内孕比较差异有显著性 (P <0 0 1) ,三组患者间孕龄和血 β HCG水平比较差异无显著性 (P >0 0 5 ) ,以子宫内膜厚度≤ 8mm为筛选异位妊娠界值时 ,预测异位妊娠发生的敏感性为 81% ,特异性为 73% ,假阳性率为 2 7% ,假阴性率为 19% ,阳性预测值为 6 7% ,阴性预测值为85 %。结论 当血 β HCG较低时超声测定子宫内膜厚度对预测异位妊娠患者具有重要参考价值
Objective To investigate whether endometrial thickness has predictive value in the diagnosis of ectopic pregnancy. Methods From June 2000 to August 2003, the endometrium of 16 4 suspected cases of ectopic pregnancy was determined by vaginal B-ultrasound in Shanghai Pudong New District Maternal and Child Health Hospital. The follow-up results were compared with those in the uterus Membrane thickness, gestational age and blood β HCG levels were compared. Results A total of 14 7 cases were complete, of which 59 (40%) were diagnosed as ectopic pregnancy, 46 (31%) were spontaneous abortions and 42 (29%) were intrauterine pregnancies. Ectopic pregnancy, spontaneous abortion and normal uterine endometrial thickness were (824 ± 143) mm, (896 ± 089) mm, (1249 ± 1655) mm, ectopic pregnancy , Spontaneous abortion and normal intrauterine pregnancy were significantly different (P <0.01), the three groups of patients with gestational age and serum β HCG levels showed no significant difference (P> 0.05), endometrial Thickness ≤ 8 mm To screen for ectopic pregnancy cutoff, the sensitivity, specificity, and false-negative predictive value for predicting ectopic pregnancy were 81%, 73%, 27%, 19%, and 6%, respectively 7%, negative predictive value of 85%. Conclusions Ultrasound determination of endometrial thickness is an important reference value for predicting ectopic pregnancy when blood β HCG is low