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血管内皮生长因子联合β-人绒毛膜促性腺激素检测对疑似异位妊娠的诊断价值
引用本文:胡花,杨晓宁,傅秀芳,顾佳士.血管内皮生长因子联合β-人绒毛膜促性腺激素检测对疑似异位妊娠的诊断价值[J].中国医师进修杂志,2011,34(15).
作者姓名:胡花  杨晓宁  傅秀芳  顾佳士
作者单位:复旦大学附属华山医院南汇分院妇产科,上海,201300
摘    要:目的 探讨血管内皮生长因子(VEGF)联合β-人绒毛膜促性腺激素(β-hCG)早期诊断异位妊娠的价值.方法 分别用双抗体夹心酶联免疫吸附法和放射免疫法测定109例疑似异位妊娠患者的血清VEGF和β-hCG水平,并建立受试者工作特征(ROC)曲线,分析VEGF和β-hCG检测对异位妊娠的诊断价值.结果 109例疑似异位妊娠患者最后确诊异位妊娠62例,宫内妊娠47例.异位妊娠患者血清VEGF水平明显高于宫内妊娠患者(P<0.05),而β-hCG水平明显低于宫内妊娠患者(P<0.05).VEGF的ROC曲线下面积为0.87,β-hCG的RO曲线下面积为0.71.以血清VEGF>140 ng/L诊断异位妊娠,其灵敏度、特异度分别是75.8%(47/62)、80.9%(38/47),以β-hCG<1200 U/L诊断异位妊娠,其灵敏度、特异度分别是64.5%(40/62)、61.7%(29/47).两者联合检测诊断异位妊娠的灵敏度、特异度分别是80.6%(50/62)、57.4%(27/47).结论 血清VEGF对异位妊娠的早期诊断优于β-hCG,两者联合检测可提高异位妊娠早期诊断率,缩短观察时间.
Abstract:
Objective To explore the diagnostic values of vascular endothelial growth factor (VEGF) and p -human chorionic gonadotropin( β -hCG) for early ectopic pregnancy. Methods The serum levels of VEGF and β-hCG were measured in 109 patients with suspected ectopic pregnancy by ELISA and RIA respectively, receiver operating characteristic (ROC) curvers were established, the diagnostic values of VEGF and β -hCG for ectopic pregnancy were analyzed. Results One hundred and nine patients with suspected ectopic pregnancy were diagnosed in the end: 62 cases with ectopic pregnancy and 47 cases with intrauterine pregnancy. The levels of VEGF in ectopic pregnancy were significantly higher than those in intrauterine pregnancy (P < 0.05), but the levels of β -hCG were significantly lower than those in intrauterine pregnancy (P < 0.05). The areas under ROC curves of VEGF were 0.87, the areas under ROC curves of β -hCG were 0.71. In VEGF > 140 ng/L for diagnosis of ectopic pregnancy, the sensitivity and specificity were 75.8% (47/62) and 80.9% (38/47) respectively. In β-hCG < 1200 U/L for diagnosis of ectopic pregnancy, the sensitivity and specificity were 64.5%(40/62) and 61.7%(29/47) respectively. The sensitivity and specificity of combined detection of VEGF and β -hCG were 80.6%(50/62) and 57.4%( 27/47) respectively. Conclusions The diagnostic values of VEGF are better than those of β -hCG. The combined detection of VEGF and β -hCG can increase the rate of early diagnosis and shorten observation time.

关 键 词:妊娠  异位  血管内皮生长因子类  绒毛膜促性腺激素  β亚单位    ROC曲线

Diagnostic value of vascular endothelial growth factor combined with β-human chorionic gonadotropin for suspected ectopic pregnancy
HU Hua,YANG Xiao-ning,FU Xiu-fang,GU Jia-shi.Diagnostic value of vascular endothelial growth factor combined with β-human chorionic gonadotropin for suspected ectopic pregnancy[J].Chinese Journal of Postgraduates of Medicine,2011,34(15).
Authors:HU Hua  YANG Xiao-ning  FU Xiu-fang  GU Jia-shi
Abstract:Objective To explore the diagnostic values of vascular endothelial growth factor (VEGF) and p -human chorionic gonadotropin( β -hCG) for early ectopic pregnancy. Methods The serum levels of VEGF and β-hCG were measured in 109 patients with suspected ectopic pregnancy by ELISA and RIA respectively, receiver operating characteristic (ROC) curvers were established, the diagnostic values of VEGF and β -hCG for ectopic pregnancy were analyzed. Results One hundred and nine patients with suspected ectopic pregnancy were diagnosed in the end: 62 cases with ectopic pregnancy and 47 cases with intrauterine pregnancy. The levels of VEGF in ectopic pregnancy were significantly higher than those in intrauterine pregnancy (P < 0.05), but the levels of β -hCG were significantly lower than those in intrauterine pregnancy (P < 0.05). The areas under ROC curves of VEGF were 0.87, the areas under ROC curves of β -hCG were 0.71. In VEGF > 140 ng/L for diagnosis of ectopic pregnancy, the sensitivity and specificity were 75.8% (47/62) and 80.9% (38/47) respectively. In β-hCG < 1200 U/L for diagnosis of ectopic pregnancy, the sensitivity and specificity were 64.5%(40/62) and 61.7%(29/47) respectively. The sensitivity and specificity of combined detection of VEGF and β -hCG were 80.6%(50/62) and 57.4%( 27/47) respectively. Conclusions The diagnostic values of VEGF are better than those of β -hCG. The combined detection of VEGF and β -hCG can increase the rate of early diagnosis and shorten observation time.
Keywords:Pregnancy  ectopic  Vascular endothelial growth factors  Chorionic gonadotropin  beta submit  human  ROC curver
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