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目的:探讨彩色多普勒超声检测子宫内膜厚度联合血清ADAM12-S(短链解整合素-金属蛋白酶12)检测对早期异位妊娠诊断的应用价值。方法:选择本院2012年1月至2015年6月孕周在5~7周的188例疑似异位妊娠孕妇为研究对象,所有患者均经病理检查及彩色多普勒超声等检测,其中异位妊娠孕妇105例,正常妊娠孕妇49例,自然流产者34例。对比3组患者的子宫内膜厚度与血清ADAM12-S水平,分析其单独及联合检测在判断异位妊娠中的符合率。结果:自然流产孕妇的血清ADAM12-S水平与孕周存在明显的正相关关系(r=0.959,P<0.01);异位妊娠孕妇的血清ADAM12-S水平显著低于正常妊娠孕妇,与孕周不相关。异位妊娠孕妇的子宫内膜厚度也显著低于正常妊娠孕妇,且与血清ADAM12-S水平呈正相关(r=0.418,P<0.05)。以子宫内膜厚度<10.83 mm为阀值诊断异位妊娠的符合率为50.5%,以孕5~7周的血清ADAM12-S水平<17.74μg·L-1为阀值诊断异位妊娠的符合率为55.2%,但两者联合诊断的符合率可提升至93.3%。结论:联合检测子宫内膜厚度与血清ADAM12-S水平诊断早期异位妊娠的准确率远高于两者单独检测。对早期疑似异位妊娠患者,应综合两项指标的结果进行准确判断,避免误诊、漏诊。
Objective: To investigate the value of color Doppler ultrasound in the detection of endometrial thickness combined with serum ADAM12-S (short-chain anti-integrin-metalloproteinase 12) in the diagnosis of early ectopic pregnancy. METHODS: A total of 188 pregnant women with suspected ectopic pregnancy who were gestational weeks between January 2012 and June 2015 at 5-7 weeks were enrolled in this study. All patients were examined by pathological examination and color Doppler echocardiography. Among them, 105 cases of pregnant women, 49 cases of normal pregnant women, spontaneous abortion in 34 cases. The endometrial thickness and serum ADAM12-S level were compared between the three groups, and the coincidence rate of single and combined detection in judging ectopic pregnancy was analyzed. Results: The level of ADAM12-S in spontaneous abortion pregnant women was significantly positively correlated with gestational age (r = 0.959, P <0.01). The serum level of ADAM12-S in pregnant women with ectopic pregnancy was significantly lower than that of normal pregnant women and gestational age irrelevant. The thickness of endometrium of ectopic pregnant women was also significantly lower than that of normal pregnant women, and positively correlated with serum ADAM12-S level (r = 0.418, P <0.05). The coincidence rate of endometrial thickness <10.83 mm for diagnosis of ectopic pregnancy was 50.5%, and the serum ADAM12-S level <17.74 μg · L-1 for 5-7 weeks of pregnancy was the threshold for the diagnosis of ectopic pregnancy The rate was 55.2%, but the coincidence rate of the two can be increased to 93.3%. Conclusion: The accuracy of combined detection of endometrial thickness and serum ADAM12-S level in the diagnosis of early ectopic pregnancy is much higher than that of the two alone. Early suspected ectopic pregnancy should be based on the results of both indicators to accurately determine, to avoid misdiagnosis, missed diagnosis.