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β-hCG 鉴别区结合子宫内膜形态对中国女性异位妊娠的诊断作用。

The diagnostic role of the β-hCG discriminatory zone combined with the endometrial pattern for ectopic pregnancy in Chinese women.

机构信息

Department of Gynecology, Jinshan Hospital of Fudan University, 1508 Longhang Rd., Shanghai, 201508, China.

Department of Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, 910 Hengshan Rd., Shanghai, 200030, China.

出版信息

Sci Rep. 2019 Sep 24;9(1):13781. doi: 10.1038/s41598-019-50151-x.

Abstract

Previous studies have regarded the discriminatory serum β-hCG zone (DSZ) as a valuable tool for the diagnosis of ectopic pregnancy (EP). However, the wide range of the DSZ makes achieving a clinical diagnosis of EP difficult, and these reports do not indicate whether the DSZ is suitable for an EP diagnosis in Chinese women. Several studies have indicated that the endometrial pattern in patients with EPs is different from that in patients with intrauterine pregnancies (IUPs). The aims of this study were to define the DSZ cutoff value for Chinese women, test whether the endometrial pattern is a suitable predictor for EP, and assess the diagnostic value of these indicators. We enrolled participants with IUPs or EPs with abdominal pain and/or vaginal bleeding, and serum β-hCG level measurements and transvaginal ultrasound (TVS) were performed to assess the diagnostic value of the indicators for EP. The sensitivity and specificity for identifying an EP were improved by combining the DSZ, endometrial thickness and trilaminar pattern indexes. The results of this study might be helpful toward providing further options for the diagnosis of EP, especially for patients without hemoperitoneum or colporrhagia.

摘要

先前的研究将血清β-hCG 离散区(DSZ)视为异位妊娠(EP)诊断的有价值的工具。然而,DSZ 的范围较宽,使得 EP 的临床诊断变得困难,并且这些报告并未表明 DSZ 是否适用于中国女性的 EP 诊断。一些研究表明,EP 患者的子宫内膜形态与宫内妊娠(IUP)患者的子宫内膜形态不同。本研究旨在为中国女性定义 DSZ 截断值,测试子宫内膜形态是否是 EP 的合适预测指标,并评估这些指标的诊断价值。我们招募了因腹痛和/或阴道出血而就诊的 IUP 或 EP 患者,并进行血清β-hCG 水平测量和经阴道超声(TVS)检查,以评估这些指标对 EP 的诊断价值。通过结合 DSZ、子宫内膜厚度和三层模式指数,可以提高识别 EP 的敏感性和特异性。本研究的结果可能有助于为 EP 的诊断提供更多选择,特别是对于没有腹腔积血或阴道出血的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/807d/6760119/7dc0409ec53e/41598_2019_50151_Fig1_HTML.jpg

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