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目的探讨早期异位妊娠患者4种血清标志物的表达并评价联合检测在早期异位妊娠患者中的诊断价值。方法化学免疫发光法检测56例早期异位妊娠患者(病例组)和60例宫内妊娠者(对照组)血清β-人绒毛膜促性腺激素(β-h CG)、孕酮(P)和雌二醇(E2)含量,对单一和联合检测结果进行诊断价值评价。结果病例组患者血清β-hCG、孕酮和E2水平明显低于对照组,而血管内皮生长因子(VEGF)水平高于对照组,差异具有统计学意义(P<0.05);单一血清标志物检测灵敏度42.86%~62.50%之间,约登指数在0.395~0.508之间,诊断价值均较低,联合检测的诊断价值高于单一血清标志物检测,其中4种血清标志物组合诊断价值最高,灵敏度为87.50%,特异度为83.33%,约登指数为0.708,阳性预测值为83.05%,阴性预测值为87.72%。结论异位妊娠患者血清标志物表达异常,联合检测可以提高诊断价值,其中4种血清标志物联合检测诊断价值最高,可作为早期异位妊娠的辅助诊断方法。
Objective To investigate the expression of four serum markers in patients with early ectopic pregnancy and evaluate the diagnostic value of combined detection in patients with early ectopic pregnancy. Methods The serum levels of β-hCG, P and P were measured by chemiluminescence immunoassay in 56 cases of early ectopic pregnancy (case group) and 60 cases of intrauterine pregnancy (control group) Estradiol (E2) content, the single and combined test results for diagnostic value evaluation. Results Serum levels of β-hCG, progesterone and E2 were significantly lower in case group than those in control group, while the level of VEGF was significantly higher than that in control group (P <0.05). Single serum markers Sensitivity between 42.86% ~ 62.50%, Youden index between 0.395 ~ 0.508, the diagnostic value is low, the diagnostic value of combined detection is higher than a single serum markers, of which four serum markers combined the highest diagnostic value, sensitivity Was 87.50%, specificity was 83.33%, Youden index was 0.708, positive predictive value was 83.05%, negative predictive value was 87.72%. Conclusions Serum markers are abnormal in patients with ectopic pregnancy, and combined detection can improve the diagnostic value. The diagnostic value of the four serum markers is the highest, which can be used as an auxiliary diagnosis method for early ectopic pregnancy.