标题：血清孕酮、血管内皮生长因子及抑制素A联合检测

      作者：在异位妊娠早期诊断中的价值
    李 沫 1，陈文科 1，邓光远 1，王三锋 2
（1.广东省中医院检验科，广东 广州 510120；
2.佛山市妇幼保健院，广东 佛山 528000）

      卷次： 2013年24卷11期

      【摘要】 目的 研究正常宫内妊娠与异位妊娠患者血清中孕酮(P)、血管内皮生长因子(VEGF)及抑制素A
(INH-A)水平的变化，探讨三者在异位妊娠早期诊断中的临床价值。方法 选取65例临床确诊为异位妊娠的患
者(观察组)及同期就诊的65例正常宫内妊娠者(对照组)进行病例对照研究。检测所有入选者的血清P、VEGF及
INH-A，并对其进行对比分析。绘制受试者工作特征(ROC)曲线，确定各指标诊断异位妊娠的截断点，并评价各
指标单独及联合应用对异位妊娠早期诊断的灵敏度和特异度。结果 观察组患者血清P、INH-A水平均低于对
照组(P值均<0.01)，观察组患者血清P、INH-A的ROC曲线下面积分别为0.89、0.82；观察组患者VEGF水平高于
对照组(P<0.01)，观察组患者血清VEGF的ROC曲线下面积为0.83。以血清P< 60.9 nmol/L为截断点，诊断异位
妊娠的灵敏度为95.4%，特异度为70.8%；以血清 INH-A<11.5 pg/ml为截断点，诊断EP的灵敏度为89.8%，特异度
为 88.7%；以血清VEGF>236.8 pg/ml为截断点，诊断EP的灵敏度为 81.5%，特异度为 90.3%；三指标联合检测的
ROC曲线下面积为0.95，灵敏度为97.1%，特异度为91.2%。结论 在异位妊娠早期诊断或在定位不明部位妊娠
时，测定血清P、VEGF及 INH-A均有一定的临床价值，三项指标联合应用可进一步提高诊断的灵敏度和特异度。

      【关键词】 异位妊娠；孕酮；血管内皮生长因子；抑制素A

      【中图分类号】 R714.22 【文献标识码】 A 【文章编号】 1003—6350(2013)11—1631—03


Value of combined detection of serum P, VEGF and INH-A in the early diagnosis of ectopic pregnancy.
LI Mo 1,
CHEN Wen-ke 1, DENG Guang-yuan 1, WANG San-feng 2. Department of Clinical Laboratory, Guangdong Provincial
Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, CHINA; 2. Foshan Maternal & Children's
Hospital, Foshan 528000, Guangdong, CHINA

【Abstract】 Objective To explore the clinical value of single and combined detection of serum markers, se-
rum progestone (serum P), vascular endothelial growth factor (VEGF) and inhibin-A (INH-A), in the early diagnosis
of ectopic pregnancy. Methods Serum P, VEGF and INH-A were measured in 65 patients with ectopic pregnancy
(the study group) and 65 healthy pregnant women (the control group). Receiver operating characteristic curves (ROC)
of all indexes were drawn, and the areas under the receiver operating characteristic curves (AUC) were calculated to
evaluate the diagnostic value. Results The levels of serum P and INH-A in the study group were significantly lower
than those in the control group (P<0.01), and the AUC of serum P and INH-A were 0.89 and 0.82. The level of VEGF
in the study group were significantly higher than that in the control group (P<0.01), and the AUC of VEGF was 0.83.
Taking serum P<60.9 nmol/L as the cut-off point, the sensitivity of the diagnosis was 95.4%, and the specificity was
70.8%; taking serum INH-A<11.5 pg/ml as the cut-off point, the sensitivity was 89.8% and the specificity was 88.7%;
taking serum VEGF>236.8 pg/ml as the cut-off point, the sensitivity was 81.5% and the specificity was 90.3%. The
AUC of the combination of the three markers was 0.95, with the sensitivity of 97.1% and the specificity of 91.2%.
Conclusion Detection of serum progestone, vascular endothelial growth factor, inhibin-A are helpful for the early di-
agnosis of ectopic pregnancy. But combination of them has more advantage compared to single determination of se-
rum markers, with higher sensitivity and specificity.

      【Key words】 Ectopic pregnancy; Progestone (P); Vascular endothelial growth factor (VEGF); Inhibin-A (INH-A)