文章摘要
邓海霞,戴 婷,吴 园,肖 炯,符声玉,莫利花.妊娠早期流产的阴道超声影像表现及与血清瘦素、ADAM12、CA-125水平的相关性研究[J].,2022,(6):1160-1164
妊娠早期流产的阴道超声影像表现及与血清瘦素、ADAM12、CA-125水平的相关性研究
Transvaginal Ultrasound Findings of Early Pregnancy Abortion and its Correlation with Serum Leptin, ADAM12 and CA-125 Levels
投稿时间:2021-08-07  修订日期:2021-08-31
DOI:10.13241/j.cnki.pmb.2022.06.034
中文关键词: 妊娠早期流产  阴道超声  瘦素  ADAM12  CA-125  相关性
英文关键词: Early pregnancy abortion  Transvaginal ultrasound  Leptin  ADAM12  CA-125  Correlation
基金项目:湖南省卫生健康委科研项目(20161328)
作者单位E-mail
邓海霞 长沙市第三医院超声诊断科 湖南 长沙 410007 jintian20210914@163.com 
戴 婷 长沙市第三医院超声诊断科 湖南 长沙 410007  
吴 园 长沙市第三医院超声诊断科 湖南 长沙 410007  
肖 炯 长沙市第三医院超声诊断科 湖南 长沙 410007  
符声玉 湖南省妇幼保健院超声科 湖南 长沙 410008  
莫利花 长沙市第三医院妇产科 湖南 长沙 410007  
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中文摘要:
      摘要 目的:探讨妊娠早期流产的阴道超声影像表现及与血清瘦素、融合素 -α(ADAM12)、糖类抗原 -125(CA-125)的相关性。方法:选取 2017年 7月 -2020年 9月于我院就诊的 419例具有早期先兆流产征象的孕妇患者,按妊娠结局分为妊娠早期流产组(流产组,61例)和正常早期妊娠组(正常组,358例)。所有患者均进行阴道超声检查,观察卵黄囊的大小和形态。测定胎儿冠臀长(CRL)、胎囊直径(GSD)、卵黄囊直径(YSD)和胎心率(FHR)。同时检测患者血清瘦素、ADAM12、CA-125水平。采用 Spearman秩相关分析评价阴道超声影像学表现与血清瘦素、ADAM12、CA-125水平的相关性。结果:正常组孕妇超声影像表现可见孕囊形态饱满,孕周和胎芽大小相符,可清晰显示原始心管、卵黄囊和胎心波动。流产组孕妇部分超声影像表现可见卵黄囊过大、过小或未见显示,胎芽略小,卵囊位置位于宫腔中下段,孕囊外形稍欠规则,同时可见原始心管或胎心波动。流产组孕妇平均 CRL、GSD、FHR均显著低于正常组,差异均有统计学意义(P<0.05);流产组患者平均 YSD稍低于常组,差异有统计学意义(P<0.05)。流产组孕妇各孕周 CRL、GSD、FHR均显著低于正常组,差异均有统计学意义(P<0.05);流产组患者第 6-7周 YSD高于正常组、第8-9周和第 10-11周 YSD低于正常组,差异均有统计学意义(P<0.05)。流产组患者血清瘦素、ADAM12水平明显低于正常妊娠组,差异有统计学意义(P<0.05),流产组患者血清 CA-125水平明显高于正常妊娠组,差异有统计学意义(P<0.05)。妊娠早期流产患者阴道超声参数 CRL、GSD、FHR与血清瘦素、ADAM12呈正相关(P<0.05),与 CA-125水平呈负相关(P<0.05)。结论:妊娠早期阴道超声及血清瘦素、ADAM12、CA-125可作为早期流产的有效预测因素,阴道超声参数 CRL、GSD、FHR与血清瘦素、ADAM12、CA-125水平具有相关性,临床可通过测定这些指标以提高妊娠早期流产预测的准确性。
英文摘要:
      ABSTRACT Objective: To investigate the transvaginal ultrasound Findings of early pregnancy abortion and its relationship with serum leptin and fusin-α(ADAM12) and carbohydrate antigen-125 (CA-125). Methods: 419 pregnant women with signs of Early Threatened Abortion Treated in our hospital from July 2017 to September 2020 were divided into early pregnancy abortion group (abortion group, 61 cases) and normal early pregnancy group (normal group, 358 cases). All patients underwent transvaginal ultrasonography to observe the size and shape of yolk sac. Fetal crown-rump length(CRL), gestational sac diameter (GSD), yolk sac diameter (YSD) and fetal heart rate (FHR) were measured. At the same time, the levels of serum leptin, ADAM12 and CA-125 were detected.Spearman rank correlation analysis was used to evaluate the correlation between transvaginal ultrasound findings and serum leptin, ADAM12 and CA-125 levels. Results: Ultrasound images of normal pregnant women showed that the shape of gestational sac was full, the gestational weeks were consistent with the size of fetal bud, and the fluctuations of original heart tube, yolk sac and fetal heart could be clearly displayed. Some ultrasonic images of pregnant women in the abortion group showed that the yolk sac was too large, too small or not shown, the fetal bud was slightly small, the egg sac was located in the middle and lower segment of the uterine cavity, the shape of the gestational sac was slightly irregular, and the fluctuation of the original heart tube or fetal heart could be seen at the same time. The mean CRL, GSD and FHR of pregnant women in abortion group were significantly lower than those in normal group (P<0.05). The mean YSD of abortion group was slightly lower than that of normal group (P<0.05). CRL, GSD and FHR of pregnant women in abortion group in each gestational week were significantly lower than those in normal group(P<0.05); YSD in the abortion group was higher than that in the normal group at 6-7 weeks, and lower than that in the normal group at 8-9 weeks and 10-11 weeks (P<0.05). The levels of serum leptin and ADAM12 in abortion group were significantly lower than those in normal pregnancy group (P<0.05), while the level of serum CA-125 in abortion group was significantly higher than that in normal pregnancy group (P<0.05). The transvaginal ultrasound parameters CRL, GSD and FHR were positively correlated with serum leptin and ADAM12 (P<0.05), and negatively correlated with the level of CA-125 (P<0.05). Conclusion: Early pregnancy transvaginal ultrasound and serum leptin, ADAM12 and CA-125 can be used as effective predictors of early abortion. Transvaginal ultrasound parameters CRL, GSD and FHR are correlated with the levels of serum leptin, ADAM12 and CA-125. These indexes can be measured to improve the accuracy of early pregnancy abortion prediction.
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