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目的探讨血管内皮生长因子(VEGF)、妊娠相关蛋白A(PAPP-A)在先兆流产、异位妊娠(EP)中的变化及其临床意义。方法选取该院妇产科2013年1月-2015年12月收集的EP患者50例(EP组)、先兆流产患者50例(先兆流产组)、正常妊娠妇女100例(正常妊娠组),分别测定3组血清中VEGF、PAPP-A水平,并评估二者联合检测对EP的诊断学价值。结果 EP组患者的血清VEGF水平显著地高于先兆流产组(P<0.05),EP组患者的血清PAPP-A水平显著地低于先兆流产组(P<0.05);先兆流产组患者的血清VEGF水平显著地高于正常妊娠组(P<0.05),先兆流产组患者的血清PAPP-A水平显著地低于正常妊娠组(P<0.05);VEGF+PAPP-A鉴别诊断EP组患者的灵敏度为90.00%、特异度为91.33%、kappa值为0.772、ROC曲线下面积AUC值为0.931。结论血清VEGF、PAPP-A水平在EP、先兆流产患者中已经发生显著的改变,联合检测VEGF、PAPP-A可显著的提高鉴别诊断EP患者的能力。
Objective To investigate the changes and clinical significance of vascular endothelial growth factor (VEGF) and pregnancy related protein A (PAPP-A) in threatened abortion and ectopic pregnancy (EP). Methods 50 cases of EP patients (EP group), 50 cases of threatened abortion (threatened abortion group) and 100 normal pregnant women (normal pregnancy group) were collected from January 2013 to December 2015 in our hospital. The serum levels of VEGF and PAPP-A in the three groups were determined, and the diagnostic value of the combination of the two in the diagnosis of EP was evaluated. Results The level of serum VEGF in EP group was significantly higher than that in threatened abortion group (P <0.05). The level of serum PAPP-A in EP group was significantly lower than that in threatened abortion group (P <0.05) (P <0.05). Serum PAPP-A levels in patients with threatened abortion were significantly lower than those in normal pregnancy (P <0.05). The sensitivity of patients with EP in the differential diagnosis of VEGF + PAPP-A was 90.00%, specificity was 91.33%, kappa value was 0.772, area under the ROC curve AUC value was 0.931. Conclusion Serum levels of VEGF and PAPP-A have been significantly changed in patients with EP and threatened abortion. Combined detection of VEGF and PAPP-A can significantly improve the ability of differentiating patients with EP.