CAJ | 학술논문

目的对比输卵管妊娠患者与早期宫内妊娠孕妇血清VEGF的浓度,以及输卵管妊娠患者的磁共振成像(MRI)表现与其VEGF水平的关系.方法随机收集2010年1月至2011年6月在本院妇科门诊和住院诊断并经手术病理证实的输卵管妊娠的患者31例[停经时间(40.5±7.1)d],以及因诊断早孕准备行人工流产术的正常宫内妊娠30例[停经时间(37.9±6.4)d].两组研究对象均于确诊妊娠后第2天空腹取肘静脉血,使用ELISA法检测血清中的VEGF水平.31例输卵管妊娠患者则于术前行盆腔平扫和增强MRI检查,分析患者的MRI表现与其VEGF水平的关系.结果输卵管妊娠患者血清VEGF浓度明显高于早期宫内妊娠的孕妇[(289.2±45.3) ng/L比(19.1±6.3)ng/L,P＜0.05].输卵管妊娠患者囊胚大小、出血、强化程度和宫腔蜕膜化积液均与血清VEGF浓度有关(均P＜0.05),而妊娠部位、盆腔积液与血清VEGF浓度无关(均P＞0.05).结论输卵管妊娠患者血清VEGF浓度显著高于早期宫内妊娠者,并可能影响囊胚的大小、强化程度、出血和宫腔蜕膜化积液.
목적 대비수란관임신환자여조기궁내임신잉부혈청VEGF적농도,이급수란관임신환자적자공진성상(MRI)표현여기VEGF수평적관계.방법 수궤수집2010년1월지2011년6월재본원부과문진화주원진단병경수술병리증실적수란관임신적환자31례[정경시간(40.5±7.1)d],이급인진단조잉준비행인공유산술적정상궁내임신30례[정경시간(37.9±6.4)d].량조연구대상균우학진임신후제2천공복취주정맥혈,사용ELISA법검측혈청중적VEGF수평.31례수란관임신환자칙우술전행분강평소화증강MRI검사,분석환자적MRI표현여기VEGF수평적관계.결과 수란관임신환자혈청VEGF농도명현고우조기궁내임신적잉부[(289.2±45.3) ng/L비(19.1±6.3)ng/L,P＜0.05].수란관임신환자낭배대소、출혈、강화정도화궁강세막화적액균여혈청VEGF농도유관(균P＜0.05),이임신부위、분강적액여혈청VEGF농도무관(균P＞0.05).결론 수란관임신환자혈청VEGF농도현저고우조기궁내임신자,병가능영향낭배적대소、강화정도、출혈화궁강세막화적액.
Objective To compare the level of serum vascular epithelial growth factor (VEGF) in patients with fallopian pregnancy and healthy controls with premature intrauterine pregnancy,and to examine the association between magnetic resonance imaging (MRI) features of fallopian pregnancy and the level of VEGF.Methods Thirty-one patients with pathology-diagnosed fallopian pregnancy [menopausal period:(40.5±7.1) days] and 30 healthy controls with premature intrauterine pregnancy pending to receive artificial abortion [menopausal period:(37.9±6.4) days] in the out-patient and in-patient departments of The Third Affiliated Hospital,Guangzhou Medical College between January 2010 and June 2011 were randomly recruited.Fasting venous blood was sampled at day 2 following confirmation of the diagnosis of pregnancy,which entailed assessment of VEGF by enzyme-linked immunosorbent assay (ELISA).The 31 patients with fallopian pregnancy underwent plain and contrast-enhanced pelvic MRI preoperatively for determination of the association between MRI features and VEGF.Results Patients with fallopian pregnancy yielded a significantly higher level of serum VEGF [(289.2±45.3) ng/L vs (19.1±6.3) ng/L,P＜0.05] than those with premature intrauterine pregnancy.Serum VEGF concentration was associated with the size of the ectopic gestational sacs,the volume of hemorrhage,the extent of enhancement and presence of uterine decidual hydrops (all P＜0.05),but not associated with the location of fallopian pregnancy and pelvic hydrops (both P＞0.05).Conclusion The level of serum VEGF in fallopian pregnancy is significantly higher than that in early intrauterine pregnancy and is associated with the size of ectopic gestational sacs,volume of hemorrhage,enhancement and presence of uterine decidual hydrops.