Volume 19 Issue 5
May  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(5): 801-804
CHEN Gui-zhen, DU Dan-li, LI Xiang, GONG Ying-ying, YANG Na-na. Application of serum markers combined with colour Doppler ultrasound in the prenatal diagnosis of pernicious placenta previa[J]. Chinese Journal of General Practice, 2021, 19(5): 801-804. doi: 10.16766/j.cnki.issn.1674-4152.001921
Citation: CHEN Gui-zhen, DU Dan-li, LI Xiang, GONG Ying-ying, YANG Na-na. Application of serum markers combined with colour Doppler ultrasound in the prenatal diagnosis of pernicious placenta previa[J]. Chinese Journal of General Practice, 2021, 19(5): 801-804. doi: 10.16766/j.cnki.issn.1674-4152.001921
shu

Application of serum markers combined with colour Doppler ultrasound in the prenatal diagnosis of pernicious placenta previa

doi: 10.16766/j.cnki.issn.1674-4152.001921

  • Department of Gynecology and Obstetrics, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 2008085QH407

  • Received Date: 2020-12-28
    Available Online: 2022-02-16
    Abstract
  •   Objective  This study aimed to explore the application value of serum matrix metalloproteinase 9 (MMP-9) and creatine kinase (CK) levels combined with colour Doppler ultrasound in the prenatal diagnosis of pernicious placenta previa.  Methods  Fifty patients with pernicious placenta previa who were delivered in the First Affiliated Hospital of Bengbu Medical College from January 2019 to August 2020 were selected as the observation group (3 patients with penetrating type, 31 patients with implanted type and 16 patients with adhesive type), and 50 cases of non-placenta previa and non-implanted patients served as the control group. Colour Doppler ultrasound, MMP-9 and CK examinations were performed after admission. Independent sample t test was used to compare two groups of general information, and one-way analysis of variance was used to compare the levels of MMP-9 and CK in each group. The cut-off value of the variable was obtained through the ROC curve, and the Delong test compared the area under the ROC curve (AUC) of each indicator individually and in combination. Respective Youden indices were compared.  Results  No significant difference in general information (age, gestational age, gestation times and parity; t=1.855, 0.669, 1.666, 0.267; all P>0.05) was found between the observation group and the control group, and the differences in the levels of MMP-9 and CK in each group were statistically significant (F=43.134, 22.600, all P < 0.05). The observation group was higher than the control group, and the level of CK in the penetrating type was higher than that in the implanted type. The implanted type was higher than the adhesive type and control group, and the level of MMP-9 was higher in the penetrating and implanted type than that in the control group (P < 0.05). The best cut-off value of CK was 38.00 U/L, and MMP-9 was 362.90 ng/mL. Furthermore, the AUC (0.902) and the Youden index (0.76) of the three combined diagnoses were greater than the detection results of each individual index.  Conclusion  Serum MMP-9 and CK levels combined with colour Doppler ultrasound can improve the prenatal diagnosis of pernicious placenta previa, which is better than the detection value of each individual index.

     

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    • References(30)
  • [1]
    蒋玲玲, 刘颖蕾, 刘曼华, 等. 凶险性前置胎盘致产后大出血患者的急症子宫切除术手术时机探讨[J]. 中华全科医学, 2017, 15(11): 1915-1917. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201711031.htm
    [2]
    杨琳琳, 孙改哲, 王娜, 等. 产前超声和生物学指标检查对凶险性前置胎盘伴胎盘植入的诊断价值[J]. 临床误诊误治, 2019, 32(12): 50-53. doi: 10.3969/j.issn.1002-3429.2019.12.011
    [3]
    孙新党, 吕林娜, 刘会敏, 等. 血清AFP及CK联合彩色多普勒超声检查在胎盘植入诊断中的应用价值[J]. 临床心身疾病杂志, 2020, 26(1): 105-108.
    [4]
    刘玉东, 甄娟, 韩晓丽, 等. 转移相关蛋白2、锌指转录蛋白与基质金属蛋白酶9在喉鳞状细胞癌中的表达及临床意义[J]. 中国耳鼻咽喉头颈外科, 2020, 27(9): 507-511. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT202009005.htm
    [5]
    张观朝, 徐兵, 陈智年. MMP9、TIMP1、CCL21在结直肠癌患者血清中的表达水平及与预后的关系[J]. 癌症进展, 2019, 17(5): 592-594. https://www.cnki.com.cn/Article/CJFDTOTAL-AZJZ201905026.htm
    [6]
    周艳. 三维能量多普勒超声联合二维彩色多普勒超声在产前子宫胎盘植入患者诊断中的应用研究[J]. 实用医学影像杂志, 2018, 19(6): 527-528. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXY201806029.htm
    [7]
    汪玉丽, 钟利捷, 周穗华, 等. 凶险型前置胎盘并胎盘植入的超声诊断声像图特征[J]. 医学影像学杂志, 2017, 27(8): 1533-1536. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ201708034.htm
    [8]
    徐国华. 不同类型凶险性前置胎盘产妇的临床特点及剖宫产结局[J]. 中国妇幼保健, 2018, 33(9): 1986-1988. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201809022.htm
    [9]
    单华英, 费敬英, 查艺葆, 等. 前置胎盘孕妇产前超声在胎盘植入诊断中的价值[J]. 中华全科医学, 2017, 15(7): 1163-1165. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201707022.htm
    [10]
    DELONG E R, DELONG D M, CLARKE-PEARSON D L. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach[J]. Biometrics, 1988, 44(3): 837-845. doi: 10.2307/2531595
    [11]
    CHEN C, LIU X, CHEN D, et al. A risk model to predict severe postpartum hemorrhage in patients with placenta previa: a single-center retrospective study[J]. Ann Palliat Med, 2019, 8(5): 611-621. doi: 10.21037/apm.2019.09.04
    [12]
    吴萍, 杨正飞, 宋成林, 等. 腹主动脉球囊阻断术联合子宫动脉栓塞术治疗凶险性前置胎盘的疗效研究[J]. 现代医药卫生, 2020, 36(4): 571-574. doi: 10.3969/j.issn.1009-5519.2020.04.029
    [13]
    KONG C W, TO W W K. Risk factors for severe postpartum haemorrhage during caesarean section for placenta praevia[J]. J Obstet Gynaecol, 2020, 40(4): 479-484. doi: 10.1080/01443615.2019.1631769
    [14]
    PIRJANI R, SEIFMANESH F, TEHRANIAN A, et al. Placental implantation and migration following a previous caesarean section scar[J]. Aust N Z J Obstet Gynaecol, 2017, 57(1): 115-117. doi: 10.1111/ajo.12555
    [15]
    吴晓兰, 张丽华, 黄梅, 等. 多学科协作治疗模式在凶险性前置胎盘中的临床应用研究[J]. 现代预防医学, 2018, 45(9): 1710-1713. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201809042.htm
    [16]
    利峰, 黄薇, 杨孔武, 等. 非杂交手术室条件下多学科协作治疗凶险性前置胎盘并胎盘植入[J]. 实用放射学杂志, 2020, 36(5): 800-803. doi: 10.3969/j.issn.1002-1671.2020.05.028
    [17]
    谢幸, 孔北华, 段涛, 等. 妇产科学[M]. 9版. 北京: 人民卫生出版社, 2018: 147-153.
    [18]
    杨红梅, 陈锰, 刘兴会. 凶险性前置胎盘的围生期管理[J]. 实用妇产科杂志, 2017, 33(9): 641-643. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201709002.htm
    [19]
    张鑫, 齐娟. 产前彩超与MRI诊断植入型凶险性前置胎盘的效果分析[J]. 中国医药导刊, 2018, 20(10): 590-592. doi: 10.3969/j.issn.1009-0959.2018.10.004
    [20]
    马再伦. 凶险型前置胎盘伴胎盘植入产前MRI诊断的影像特征及诊断价值[J]. 中国计划生育学杂志, 2019, 27(1): 80-83. https://www.cnki.com.cn/Article/CJFDTOTAL-JHSY201901025.htm
    [21]
    姚继芹, 俞琤, 高建松, 等. 超声及MRI检查对穿透性凶险型前置胎盘的诊断价值[J]. 浙江医学, 2019, 41(9): 956-958. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201909032.htm
    [22]
    岑炳奎, 王儒发, 邓祖群, 等. 比较彩超和MRI在凶险型前置胎盘产前诊断中的价值[J]. 影像研究与医学应用, 2019, 3(13): 166-168. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY201913108.htm
    [23]
    张建红, 郝风华, 赵海燕, 等. 彩色多普勒超声与MRI产前诊断凶险性前置胎盘的价值分析[J]. 现代医用影像学, 2017, 26(1): 156-159. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY201701054.htm
    [24]
    单华英, 费敬英, 查艺葆, 等. 前置胎盘孕妇产前超声在胎盘植入诊断中的价值[J]. 中华全科医学, 2017, 15(7): 1163-1165. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201707022.htm
    [25]
    倪雪梅, 赖微, 朱巧英, 等. 彩超联合甲胎蛋白在孕晚期预测凶险性前置胎盘合并胎盘植入的应用分析[J]. 中国计划生育和妇产科, 2017, 9(8): 53-56. doi: 10.3969/j.issn.1674-4020.2017.08.15
    [26]
    葛桂霞, 胡晓阳, 于海燕. 彩超联合肌酸激酶检测在凶险型前置胎盘伴胎盘植入产前诊断中的价值[J]. 中国医师杂志, 2019, 21(4): 605-607. doi: 10.3760/cma.j.issn.1008-1372.2019.04.034
    [27]
    秦喆, 侯海燕, 史海霞, 等. MMP-2和MMP-9参与多种因素对胎盘滋养细胞侵袭力的调控[J]. 国际妇产科学杂志, 2017, 44(3): 350-355. doi: 10.3969/j.issn.1674-1870.2017.03.029
    [28]
    韦婵妍, 黄琼华. 葡萄胎恶变相关因素及MMP-9在妊娠滋养细胞疾病中表达的临床意义[J]. 岭南急诊医学杂志, 2018, 23(2): 148-150. doi: 10.3969/j.issn.1671-301X.2018.02.018
    [29]
    赵天源, 张艳敏, 常延河. 非小细胞肺癌组织中HAb18G、MMP-9和MMP-2表达与预后的相关性[J]. 临床与实验病理学杂志, 2020, 36(7): 819-822. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL202007016.htm
    [30]
    张雅琪, 吴媛媛, 刘海意, 等. 缺氧调控滋养细胞MMP-9/TIMP-1表达及侵袭能力的体外研究[J]. 现代妇产科进展, 2014, 23(2): 117-120. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC201402010.htm
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