标题：血清VEGF、PAPP-A及P联合测定对早期诊断异位妊娠及稽留流产的临床价值

      作者：李永红 1，生秀杰 2    (1.广州医科大学附属深圳沙井医院妇科，广东 深圳 440306；2.广州医科大学附属三院妇科，广东 广州 518104)

      卷次： 2017年28卷19期

      【摘要】 目的 探讨血清血管内皮生长因子(VEGF)、妊娠相关蛋白A (PAPP-A)、孕酮(P)联合测定[即公式VEGF/(PAPP-Ａ×P)]在早期诊断异位妊娠及稽留流产中的应用价值。方法 选择深圳沙井医院妇产科于2015年1月至2016年12月期间收治的宫内早孕、稽留流产及异位妊娠各40例作为研究对象，检测并比较三组受检者血清血管内皮生长因子(VEGF)、妊娠相关蛋白A (PAPP-A)、孕酮(P)水平，计算VEGF/(PAPP-A×P)，比较三组上述指标的差异。结果 异位妊娠组患者的血清VEGF为(298.1±32.6) pg/mL，明显高于稽留流产组的(224.5±30.2) pg/mL和宫内早孕组的(211.4±24.7) pg/mL，差异均有统计学意义(P<0.05)；稽留流产组与异位妊娠组患者的血清PAPP-A及P分别为(243.2±22.4) pg/mL、(36.4±15.3) nmol/L和(234.3±23.5) pg/mL、(32.6±13.6) nmol/L，差异均无统计学意义(P>0.05)，但均明显低于宫内早孕组的(291.6±32.7) pg/mL、(66.2±19.4) nmol/L，差异均有统计学意义(P<0.05)；VEGF/(PAPP-A×P)在异位妊娠组、稽留流产组、宫内早孕组分别为(0.096±0.032)、(0.056±0.023)、(0.024±0.005)，三组间逐渐下降，两两比较差异均有统计学意义(P<0.05)；VEGF/(PAPP-A×P)=0.086为界值，其对异位妊娠诊断敏感性93.8%，特异性92.1%。结论 运用公式VEGF/(PAPP-A×P)对异位妊娠及稽留流产具有较好的早期诊断及鉴别作用，优于VEGF、PAPP-A、P的单项测定。
      【关键词】 异位妊娠；稽留流产；血管内皮生长因子；妊娠相关蛋白A；孕酮
      【中图分类号】 R714.22 【文献标识码】 A 【文章编号】 1003—6350（2017）19—3150—03

Value of combined determination of serum VEGF, PAPP-A and P in early diagnosis of ectopic pregnancy andmissed abortion.
LI Yong-hong 1, SHENG Xiu-jie 2. 1. Department of Gynaecology, Shenzhen Shajing Hospital Affiliated toGuangzhou Medical University, Shenzhen 440306, Guangdong, CHINA; 2. Department of Gynaecology, the Third AffiliatedHospital of Guangzhou Medical University, Guangzhou 518104, Guangdong, CHINA
【Abstract】 Objective To investigate the value of combined determination of serum vascular endothelialgrowth factor (VEGF), pregnancy-associated plasma protein A (PAPP-A) and progesterone (P), by formula VEGF/(PAPP-A×P), in early diagnosis of ectopic pregnancy and missed abortion. Methods From January 2015 to Decem-ber 2016, 40 patients with intrauterine early pregnancy, 40 patients with missed abortion, and 40 patients with ectopicpregnancy in Department of Obstetrics and Gynecology in our hospital were selected as research objects. The serumlevels of VEGF, PAPP-A and P in three groups were detected and compared. Results The serum VEGF level of ecto-pic pregnancy group was (298.1±32.6) pg/mL, significantly higher than (224.5±30.2) pg/mL in missed abortion groupand (211.4±24.7) pg/mL in intrauterine early pregnancy group (P<0.05). PAPP-A, P levels were (243.2±22.4) pg/mL,·论 著·doi:10.3969/j.issn.1003-6350.2017.19.018