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目的探讨阴道三维能量多普勒超声(3D-PDU)联合胚胎植入相关因子检测宫外孕的应用价值。方法选取妇科就诊的门诊拟诊宫外孕患者25例作为试验组,同期因个人原因需行人工流产的宫内妊娠25例作为对照组。对两组患者进行阴道3D-PDU,采用三维重建技术和VOCAL软件观察妊娠黄体血流分布,测量血管化指数(VI)、血流指数(FI)和血管化血流指数(VFI);抽取患者静脉血,采用酶联免疫法检测两组患者血清中胚胎植入相关因子(PROKs、h CG、VEGF和PIGF)的蛋白含量水平。结果与对照组比较,试验组患者的VI、VFI和PIGF均降低,差异有统计学意义(P<0.05),FI略降低但差异无统计学意义(P>0.05);试验组患者的PROKs、h CG、VEGF均升高,差异有统计学意义(P<0.05)。结论阴道3D-PDU能更为精确地反映患者妊娠黄体血流分布情况,联合检测患者血清中胚胎植入相关因子的蛋白含量水平,对更好的监测宫外孕的诊断符合率具有重要临床意义。
Objective To investigate the value of three-dimensional vaginal three-dimensional energy Doppler ultrasound (3D-PDU) combined with embryo implantation-related factors in detecting ectopic pregnancy. Methods Twenty-five outpatients diagnosed as ectopic pregnancy by gynecological clinic were selected as the experimental group. Twenty-five intrauterine pregnancies requiring artificial abortion during the same period were selected as the control group. Vaginal 3D-PDU was performed on both groups. The distribution of luteal flow in pregnancy was observed by three-dimensional reconstruction and VOCAL software. The vascularization index (VI), blood flow index (FI) and vasculogenic blood flow index (VFI) were measured. The serum levels of PROKs, hCG, VEGF and PIGF in sera of two groups were detected by enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, the levels of VI, VFI and PIGF in the experimental group were significantly lower (P <0.05), while FI in the experimental group was lower but the difference was not statistically significant (P> 0.05). The PROKs, h CG, VEGF were increased, the difference was statistically significant (P <0.05). Conclusions Vaginal 3D-PDU can reflect the distribution of luteal flow in pregnant women more accurately, and the combined detection of protein levels of embryo implantation related factors in serum has important clinical significance for better monitoring the coincidence rate of ectopic pregnancy.