【摘要】 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。更多还原

【Abstract】 Objective:to explore the value of combined measurement of transvaginal color Doppler sonography and progesterone in the early pregnancy outcome of threatened abortion.MethodsAtotal of 138 gravidasbetween 5-8 weeks pregnantwere examined by transvaginal colorDopplerfor RI、PI of uterine spiral arteries and corpus luteum, The level of serum progesterone wasmeasured by chemiluminescence.Group Awas defined as normal control group(46 women);Group B was defined as threatened abortionwomen(92 women),All of them followed to 16 weeks pregnant,continue to pregnancies as successful as group B1,otherwise patient classified as Group B2.Compare the differencesbetween 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 Aand 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 B1and 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 were85.9%,89.8%,81.3%.Thatwere 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.更多还原