| 杨静,吕小英,马馨玉,等.宫颈弹性成像参数联合孕晚期血清 HCG预测双胎妊娠自发性早产的效能分析[J].安徽医药,2025,29(4):700-705. |
| 宫颈弹性成像参数联合孕晚期血清 HCG预测双胎妊娠自发性早产的效能分析 |
| Efficacy analysis of cervical elastography parameters combined with late pregnancy serum HCG in predicting spontaneous preterm delivery of twin pregnancy |
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| DOI：10.3969/j.issn.1009-6469.2025.04.013 |
| 中文关键词: 妊娠，双胎 宫颈弹性成像 人绒毛膜促性腺激素 早产 预测价值 |
| 英文关键词: Pregnancy, twin Cervical elastography Human chorionic gonadotropin Premature birth Predictive value |
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| 摘要点击次数: 193 |
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| 中文摘要: |
| 目的探讨宫颈弹性成像参数联合孕晚期血清人绒毛膜促性腺激素( HCG)预测双胎妊娠自发性早产的效能。方法选取 2017年 1月至 2023年 3月在惠州市第六人民医院产检的 132例孕晚期双胎妊娠孕妇设为研究组，另选取同期在该院体检的 132例同孕周单胎妊娠孕妇设为对照组，两组行宫颈弹性成像超声检查和血清 HCG水平检测并比较。随访至生产，根据妊娠结局将研究组病人分为早产组( n=62)和足月产组( n=70)比较两组孕妇的宫颈弹性成像参数［弹性对比指数( ECI)、宫颈内口应变值(IOS)、宫颈外口应变值( EOS)硬度比值(HR)］和血清，HCG水平。采用 logistic回归分析法分析双胎妊娠自发性早产的影响因素，另采用受试者操作特征曲线(、ROC曲线)分析宫颈弹性成像参数联合孕晚期血清 HCG对双胎妊娠自发性早产的预测价值。结果研究组的 ECI(4.08±0.59比 3.62±0.54)、 IOS［0.34(0.28，0.40)比 0.28(0.22，0.36)］、 EOS［0.35(0.32，0.39)比 0.30(0.26，0.37)］及血清 HCG水平［(31 606.57±5 416.54)IU/L比( 23 537.62±4 635.07)IU/L］均高于对照组( P<0.05)HR低于对照组( P<0.05)；早产组的 ECI、IOS、EOS及血清 HCG水平均高于足月产组， HR低于足月产组( P<0.05)。 logistic回归，分析结果显示，单绒毛膜性双胎、阴道炎、 ECI、IOS、EOS、HR及血清 HCG水平均为双胎妊娠自发性早产的影响因素( OR=2.16、2.13、1.87、2.03、1.66、0.58、1.62，P<0.05)。 ECI、IOS、EOS、HR联合预测的灵敏度、曲线下面积( AUC)、特异度分别为 79.03%、0.86、84.29%，其中特异度、 AUC均高于单项参数预测( P<0.05)灵敏度与单项参数预测相差较小。宫颈弹性成像参数和孕晚期血清 HCG联合预测的灵敏度、 AUC、特异度分别为 95.16%、 3、78.57%，其中灵敏度、 AUC均高于单独预测( P<0.05)特异度与单独预测相差较小。结论与足月产孕妇相比，双胎妊娠自发性早产孕妇的 ECI、IOS、EOS及孕晚期血清 HCG更R更低，0.9，高，H，且以上指标均为双胎妊娠自发性早产的影响因素，对自发性早产的发生具有预测价值，而联合预测的效能更好。 |
| 英文摘要: |
| Objective To explore the efficacy of cervical elastography parameters combined with late pregnancy serum human chori.onic gonadotropin (HCG) in predicting spontaneous preterm delivery of twin pregnancy.Methods A total of 132 late pregnancy twinpregnant women who underwent prenatal examination at Huizhou Sixth People's Hospital from January 2017 to March 2023 were se.lected as the research group, and 132 single pregnancy pregnant women of the same gestational week who underwent physical examina.tion in Huizhou Sixth People's Hospital during the same period were selected as the control group, and the cervical elastography ultra.sound examination and serum HCG level detection were performed and compared between the two groups. Followed up until delivery,the research group patients were divided into premature delivery group (n=62) and term delivery group (n=70) based on pregnancy out.comes. The cervical elastography parameters [elasticity contrast index (ECI), internal os strain (IOS), external os strain (EOS), hardnessratio (HR)] and serum HCG level were compared between two groups of pregnant women. The influencing factor of spontaneous prema.ture delivery in twin pregnancies was analyzed by using Logistic regression analysis, and the predictive value of cervical elastographyparameters combined with late pregnancy serum HCG for spontaneous preterm delivery in twin pregnancy was analyzed by using the re.ceiver operating characteristic curve(ROC curve).Results The ECI [(4.08±0.59) vs. (3.62±0.54)], IOS [0.34 (0.28, 0.40) vs. 0.28 (0.22, 0.36)], EOS [0.35 (0.32, 0.39) vs. 0.30 (0.26, 0.37)] and serum HCG level [(31 606.57±5 416.54) IU/L vs. (23 537.62±4 635.07) IU/L] in the research group were higher than those in the control group (P<0.05), while HR was lower than that in the control group (P<0.05).The ECI, IOS, EOS and serum HCG level in the premature delivery group were higher than those in the term delivery group, while HRwas lower than that in the term delivery group (P<0.05). The results of Logistic regression analysis showed that single chorionic twin,vaginitis, ECI, IOS, EOS, HR and serum HCG level were all influencing factors for spontaneous preterm delivery in twin pregnancy (OR =2.16, 2.13, 1.87, 2.03, 1.66, 0.58, 1.62, P<0.05). The sensitivity, area under curve (AUC) and specificity of the combined prediction ofECI, IOS, EOS and HR were 79.03%, 0.86 and 84.29% respectively, and the specificity and AUC were higher than those of single pa.rameter prediction (P<0.05), but the difference in sensitivity between combination and single parameter prediction was small. The sen.sitivity, AUC and specificity of the combined prediction of cervical elastography parameters and late pregnancy serum HCG were95.16%, 0.93 and 78.57% respectively, and the sensitivity and AUC were higher than those of single prediction (P<0.05), but the differ. ence in specificity between combination and single parameter prediction was small.Conclusions Compared with full term pregnantwomen, the ECI, IOS, EOS and late pregnancy serum HCG of pregnant women with spontaneous preterm delivery in twin pregnancy arehigher, while HR is lower. The above indicators are all influencing factors for spontaneous preterm delivery of twin pregnancy, and theyhave predictive value for the occurrence of spontaneous preterm delivery, but the joint prediction has better effectiveness. |
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