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目的分析VEGF/(PAPP-A×P)预判早期未知部位妊娠结局的可行性,为临床早期诊断异位妊娠提供依据。方法选择在广州医科大学附属深圳沙井医院妇科门诊就诊的129例早期不明位置妊娠(PUL)患者,根据随访确诊结果分为异位妊娠组(75例)与正常宫内妊娠组(54例)。分别检测两组血管内皮生长因子(VEGF)、妊娠相关蛋白A(PAPP-A)及孕酮(P)水平,并分析运用公式VEGF/(PAPP-A×P)诊断异位妊娠的可行性。结果异位妊娠组VEGF水平及VEGF/(PAPP-A×P)值高于正常宫内妊娠组,PAPP-A、P水平低于正常宫内妊娠组,差异有统计学意义(P<0.05);运用公式VEGF/(PAPP-A×P)诊断异位妊娠的灵敏度、特异度分别为97.02%、92.24%,均高于VEGF、PAPPA、P单独测定,差异有统计学意义(P<0.05)。结论运用公式VEGF/(PAPP-A×P)诊断异位妊娠具有较高的灵敏度及特异度,优于VEGF、PAPP-A、P单独测定,可提高早期可疑异位妊娠的确诊率,降低孕产妇病死率。
OBJECTIVE: To analyze the feasibility of predicting the pregnancy outcome of early stage unknown sites by VEGF / (PAPP-A × P), and to provide basis for early diagnosis of ectopic pregnancy. Methods A total of 129 patients with early-stage unknown pregnancy (PUL) who were treated at the gynecological clinic of Shenzhen Shajing Hospital affiliated to Guangzhou Medical University were divided into ectopic pregnancy group (n = 75) and normal intrauterine pregnancy group (n = 54) according to the follow-up results. The levels of vascular endothelial growth factor (VEGF), pregnancy-related protein A (PAPP-A) and progesterone (P) in the two groups were detected and the feasibility of using the formula VEGF / (PAPP-A × P) to diagnose ectopic pregnancy was analyzed. Results The level of VEGF and the level of VEGF / (PAPP-A × P) in ectopic pregnancy were significantly higher than those in normal pregnant women and the levels of PAPP-A and P were lower than those in normal pregnant women (P <0.05) . The sensitivity and specificity of using the formula VEGF / (PAPP-A × P) in diagnosing ectopic pregnancy were 97.02% and 92.24%, respectively, which were higher than those of VEGF, PAPPA and P alone (P0.05) . Conclusion The diagnosis of ectopic pregnancy using the formula VEGF / (PAPP-A × P) has a higher sensitivity and specificity, better than VEGF, PAPP-A, P alone can increase the early diagnosis of suspected ectopic pregnancy and reduce pregnancy Maternal mortality.