CAJ | 학술논문

提目的：探讨经阴道二维彩色多普勒超声与血清孕酮联合检测对先兆流产预后判断的价值。方法随机选取孕5-8周早孕患者138例，其中正常宫内早孕（A ）组46例，早期先兆流产92例（B ），分别行经阴道彩色多普勒超声检测子宫螺旋动脉、黄体血流的 RI、PI值及化学发光法检测血清孕酮水平，随访先兆流产者至16周孕，继续妊娠者视为保胎成功归入B1组，反之则归入B2组，比较其各组间的差异并研究各指标单检及联合检测对预后判断的价值。结果：子宫螺旋动脉RI、PI值，黄体血流 RI、PI值及血清孕酮值在A、B组间差异有统计学意义（P＜0．05）；其中子宫螺旋动脉RI、黄体血流RI及血清孕酮值在B组内（B1与B2组间）差异有统计学意义（P＜0．05）。子宫螺旋动脉RI、黄体血流 RI及孕酮三者联合检测对先兆流产预后判断的准确性、特异性及阳性预测值分别为85．9％、89．8％、81．3％，较各指标单检及两联检测均高，差异有统计学意义（P＜0．05）。结论：血清孕酮联合彩色多普勒超声检测子宫螺旋动脉RI及黄体血流RI能够明显提高先兆流产预后判断的准确性、特异性及阳性预测值，对准确判断先兆流产预后具有重要临床意义。
제목적：탐토경음도이유채색다보륵초성여혈청잉동연합검측대선조유산예후판단적개치。방법수궤선취잉5-8주조잉환자138례，기중정상궁내조잉（A ）조46례，조기선조유산92례（B ），분별행경음도채색다보륵초성검측자궁라선동맥、황체혈류적 RI、PI치급화학발광법검측혈청잉동수평，수방선조유산자지16주잉，계속임신자시위보태성공귀입B1조，반지칙귀입B2조，비교기각조간적차이병연구각지표단검급연합검측대예후판단적개치。결과：자궁라선동맥RI、PI치，황체혈류 RI、PI치급혈청잉동치재A、B조간차이유통계학의의（P＜0．05）；기중자궁라선동맥RI、황체혈류RI급혈청잉동치재B조내（B1여B2조간）차이유통계학의의（P＜0．05）。자궁라선동맥RI、황체혈류 RI급잉동삼자연합검측대선조유산예후판단적준학성、특이성급양성예측치분별위85．9％、89．8％、81．3％，교각지표단검급량련검측균고，차이유통계학의의（P＜0．05）。결론：혈청잉동연합채색다보륵초성검측자궁라선동맥RI급황체혈류RI능구명현제고선조유산예후판단적준학성、특이성급양성예측치，대준학판단선조유산예후구유중요림상의의。
Objective :to explore the value of combined measurement of transvaginal color Doppler sonography and progesterone in the early pregnancy outcome of threatened abortion .Methods A total of 138 gravidas between 5 -8 weeks pregnant were examined by transvaginal color Doppler for RI 、PI of uterine spiral arteries and corpus luteum ,The level of serum progesterone was measured by chemiluminescence .Group A was defined as normal control group (46 women );Group B was defined as threatened abortion women (92 women ) ,All of them followed to 16 weeks pregnant ,continue to pregnancies as successful as group B 1 , otherwise patient classified as Group B 2 .Compare the differences between the groups and estimate the value of index single inspection and combined detection for pregnancy outcome .Results The differences of RI ,PI of uterine spiral arteries and RI ,PI of corpus luteum and serum progesterone between group A and B had statistical significance (P< 0 .05 ) , especially the difference of RI of uterine spiral arteries and RI of corpus luteum and serum progesterone within group B (between group B1 and B2)had statistical significance (P< 0 .05) .The accuracy ,specificity and Positive predictive value for combined measurement of RI of uterine spiral arteries and RI of corpus luteum and serum progesterone were 85 .9% ,89 .8% ,81 .3% .That were higher than two combined measurement and respective measurement of them ,statistical differences between them (P<0 .05) .Conclusion Combined measurement of serum progesterone and transvaginal color Doppler detected RI of uterine spiral arteries and corpus luteum can improve diagnosis accuracy ,specificity and Positive predictive value for pregnancy outcome .It have important clinical significance for predicting the outcome of threatened miscarria .