Objective To investigate the value of combined determination of serum vascular endothelial growth 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 ectopic pregnancy in Department of Obstetrics and Gynecology in our hospital were selected as research objects. The serum levels 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 group and (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,(36.4 ± 15.3) nmol/L in missed abortion group versus (234.3 ± 23.5) pg/mL, (32.6 ± 13.6) nmol/L in ectopic pregnancy group (P>0.05), which were all significantly lower than (291.6 ± 32.7) pg/mL, (66.2 ± 19.4) nmol/L in intrauterine early pregnancy group (P<0.05). VEGF/(PAPP-A × P) gradually decreased in ectopic pregnancy group, missed abortion group and intrauterine early pregnancy group, which were (0.096±0.032), (0.056±0.023), (0.024±0.005), respectively, with sig-nificant differences between each two of the three groups (P<0.05). Critical value of VEGF/(PAPP-A×P) was 0.086, and its sensitivity and specificity for ectopic pregnancy diagnosis was 93.8%, 92.1%, respectively. Conclusion Using the formula VEGF/(PAPP-A × P) is of good effect for early diagnosis and differentiation on ectopic pregnancy and missed abortion, which is better than that of single detection of VEGF, PAPP-A, P.%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.
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