血栓调节素及CA125联合超声检查对胎盘早剥的早期诊断价值

摘要

Objective To investigate the early diagnostic value of thrombomodulin(TM) and CA125 combined with ultrasound examination for placental abruption. Methods One hundred pregnant women with high risk factors of placental abruption, according to the test results of TM.CA125 and ultrasound examination were divided into three groups; three indexes were positive for positive group(n =33) ;Ultrasound examination was negative,TM or/and CA125 check were positive for suspicious group(n =49) ;the three indexes were negative for negative groups(n = 16). At the same time,one hundred cases of normal pregnant women were chosen as a normal group. All pregnant women were followed-up to termination of pregnancy. The final diagnosis of placental abruption was determined by the placenta stripping and placenta pathological examination after natural labor or cesarean section. The levels of plasma TM and serum CA125 were detected and compared. The detection rates of plasma TM and serum CA125 combined with ultrasound examination for placental abruption were analyzed. Results The rate of placental abruption in positive group was significantly higher than these in suspicious group and negative groups(P < 0.05 ). There was no statistical difference in the levels of serum CA125 and plasma TM between negative group and normal group (P > 0. OS). The levels of serum CA125 and plasma TM in positive group and suspicious group were significantly higher than these in normal group(P <0.05,P <0.01). The detection rate of three indexes joint detection for placental abruption was significantly higher than that of one index detection and serum CA125 and plasma TM joint detection(P <0.01). Conclusion The levels of plasma TM and serum CA125 in pregnant woman with placental abruption are significantly higher,TM and CA125 combined with ultrasound examination can improve the detection rate of early placental abruption.%目的 探讨血栓调节素(TM)、CA125联合超声检查早期诊断胎盘早剥的临床价值.方法 100例有胎盘早剥高危因素孕妇根据血浆TM水平、血清CA125水平和经腹部B超检查结果分为3组:阳性组(3指标均阳性)35例、可疑组(超声检查阴性,TM阳性或CA125阳性或2项皆为阳性)49例和阴性组(3指标均阴性)16例；同时选取100例足月的正常孕妇作为正常组；随访至终止妊娠,胎盘早剥最终诊断由检查顺产后或剖宫产术后胎盘剥离情况及胎盘病理检查确定.对比分析各组孕妇血浆TM及血清CA125水平,以及血浆TM、血清CA125检测和超声检查对胎盘早剥的检出率.结果 阳性组胎盘早剥发生率明显高于可疑组和阴性组(P＜0.05).阴性组与正常组孕妇的血清CA125、血浆TM水平比较差异无统计学意义(P＞0.05)；可疑组、阳性组孕妇血清CA125、血浆TM水平均显著高于正常组(P＜0.05,P＜0.01).3项指标联合检测对胎盘早剥的检出率明显高于各项单独指标及血清CA125和血浆TM联合检测(P＜0.01).结论 胎盘早剥孕妇血浆TM和血清CA125水平明显升高,TM、CA125联合超声检查能提高早期胎盘早剥的检出率.