Logistic回归和ROC曲线分析孕酮、β-HCG、CA125对早期先兆流产患者妊娠结局的诊断价值

摘要

目的 探讨Logistic回归和ROC曲线综合分析孕酮、β-HCG、血清糖链蛋白125(CA125)联合检测在预测早期先兆流产患者妊娠结局的研究价值.方法 随机选择2014年8月～2016年10月期间在笔者医院进行孕检的妊娠5～7周先兆流产的孕妇150例作为研究对象,根据妊娠结局将该组患者分为继续妊娠组和难免流产组,所有先兆流产患者在接受治疗前均检测孕酮、β-HCG、CA125水平.另外随机选择同期在笔者医院进行孕检的70例正常妊娠的孕妇作为对照组,并检测其孕酮、β-HCG、CA125水平,随访所有患者至妊娠12周,采用Logistic回归和ROC曲线综合分析孕酮、β-HCG、CA125水平联合检测诊断先兆流产患者妊娠结局的价值.结果 7例先兆流产组患者脱落.正常妊娠组和继续妊娠组先兆流产患者的孕酮、β-HCG、CA125水平明显高于难免流产组,差异有统计学意义(P＜0.05).妊娠5～7周孕酮、β-HCG、CA125检测早期先兆流产的ROC曲线下面积分别为0.764、0.688、0.870,联合检测预测早期先兆流产的ROC曲线下面积为0.916.孕酮、β-HCG、CA125以及三者联合检测难免流产的敏感度为76.54％、61.05％、73.15％、89.09％,特异性为78.63％、72.38％、69.54％、93.25％,准确度分别为74.43％、70.15％、65.33％、89.77％.结论 妊娠5-7周时孕酮、β-HCG、血清CA125联合检测预测难免流产具有很高的临床诊断价值.%Objective To study the value of progesterone,β-HCG and serum streptavidin 125 (CA125) in predicting the outcome of pregnancy in patients with early threatened abortion by Logistic regression and ROC curve.Methods A total of 150 pregnant women who were pregnant with infertility from 5 to 7 weeks of gestation were enrolled in this study from August 2014 to October 2016.According to the outcome of pregnancy,the patients were divided into two groups:pregnancy group and spontaneous abortion group.Serum levels of progesterone,β-HCG and CA125 were detected in all patients with threatened abortion before treatment.The levels of progesterone,β-HCG and CA125 were detected in all the pregnant women with normal pregnancy in our hospital for the same period.All patients were followed up for 12 weeks.Logistic regression and ROC curve were used to analyze the value of progesterone,β-HCG and CA125 in the diagnosis of pregnant patients with threatened abortion.Results Seven cases of threatened abortion patients off.The levels of progesterone,β-HCG and CA125 in the normal pregnant group and the pregnant group were significantly higher than those in the abortion group (P ＜0.05).The area under the ROC curve of progesterone,β-HCG and CA125 in the early stage of pregnancy were 0.764,0.688 and 0.870 respectively.The area under the ROC curve of the early threatened abortion was 0.916.The specificity of progesterone,β-HCG,CA125 and the combined detection were 76.54％,61.05％,73.15％,89.09％,the specificity were 78.63％,72.38％,69.54％ and 93.25％ respectively,and the accuracy were 74.43％,70.15％,65.33％,89.77％.Conclusion The combination of progesterone,β-HCG and serum CA125 in the 5 ～ 7 weeks of pregnancy has a high clinical diagnostic value in prediction inevitable abortion.