产前检测外周血AFP CK水平联合彩超检查对胎盘植入的诊断价值

摘要

Objectives To predict the clinical value in prenatal diagnosing placenta accrete by combined Color Doppler ultrasound measurement of alpha-fetoprotein (AFP) and creatine kinase (CK) in maternal blood volume of the relationships among second trimester ultrasound and placental location, AFP values and pemicious placenta previa and placental implantation.Methods A retrospective analysis of230 cases treated pregnant in the period from January 2015 to January 2016 were divided into 3 groups:placental implantation (70 cases), high risk (90 cases) and control group (70 cases).AFP value, CK value and Color Doppler ultrasound were collected retrospectively of 34-38 weeks of pregnancy.The accuracy among ultrasound placental location, AFP values and CK value were analyzed.Results AFP value and CK value of placenta accrete were higher than non-placenta accrete and control group.The difference was of statistical significance (P＜0.05).And cut off values were 292.4 ng/ml and 87 U/L, respectively.The accuracy of ultrasound combinedAFP and CK determination in predicting placenta accrete was higher than applying ultrasound test alone.(P＜0.05).Conclusion The levels of AFP and CK combined with Color Doppler ultrasound measurement may be helpful to predict placenta accrete prenatally.%目的 探讨血清甲胎蛋白(AFP)、血清肌酸激酶(CK)检测联合彩色多普勒超声成像检查对胎盘植入的临床诊断价值.方法 回顾性分析2015年1月至2016年1月产科检查并分娩的妊娠妇女230例,分为胎盘植入组(70例)、高危因素组(90例)和对照组(70例).通过对三组孕妇在孕34～38周血清AFP、CK水平检测及彩色多普勒超声声像表现,比较单独彩色多普勒超声与三者联合对胎盘植入产前诊断的灵敏度与特异性.结果 胎盘植入组孕妇的血清AFP、CK水平明显高于高危组与对照组,差异均有统计学意义(P＜0.05),cut off值分别为292.4 ng/ml和87 U/L.AFP、CK水平测定联合彩色多普勒超声检查较三者单独诊断胎盘植入的灵敏度和特异度均有所提高,差异有统计学意义(P＜0.05).结论 AFP、CK及彩色多普勒超声联合检查可显著增加胎盘植入产前诊断的灵敏度,提高特异性,优于彩色多普勒等单项检测结果.