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中华妇幼临床医学杂志(电子版) ›› 2011, Vol. 07 ›› Issue (02) : 160 -163. doi: 10.3877/cma.j.issn.1673-5250.2011.02.024

综述

异位妊娠无创诊断的研究进展
强昀, 熊俊   
  1. 100080 北京,北京市海淀区妇幼保健院检验科
  • 出版日期:2011-04-01

Research Progress of Non-Invasive Diagnosis of Ectopic Pregnancy

Yun QIANG, Jun XIONG   

  1. Department of Clinical Laboratory, Haidan Maternal and Child Health Hospital, Beijing 100080, China
  • Published:2011-04-01
引用本文:

强昀, 熊俊. 异位妊娠无创诊断的研究进展[J]. 中华妇幼临床医学杂志(电子版), 2011, 07(02): 160-163.

Yun QIANG, Jun XIONG. Research Progress of Non-Invasive Diagnosis of Ectopic Pregnancy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2011, 07(02): 160-163.

长期以来,腹腔镜检查和清宫术后病理学诊断,被认为是异位妊娠(ectopic pregnancy,EP)诊断的"金标准" ,但二者均有创。相关新型血清标志物的发现、经阴道超声(transvaginal sonography,TVS)等新技术的应用及相关临床指标评分系统的建立,使异位妊娠无创诊断的准确性提高,但单独血清学或影像学检测指标在异位妊娠鉴别诊断中均存在不足,采取联合诊断已成共识。Logistic诊断模型、Bayes判别分析等诊断模型的建立,使异位妊娠的联合诊断更科学和实用,Meta分析使诊断效能评价更准确。随着各种诊断模型的优化,异位妊娠的无创诊断将广泛应用于临床。

For a long time, pathological diagnosis after laparoscopy and uterine curettage has been regarded as the golden standard for the diagnosis of ectopic pregnancy (EP). But both of them are invasive to some extend. Combined multi-noninvasive markers diagnosis, including neo-serum biomarkers, transvaginal sonography (TVS) and clinical presentation, has become a consensus. By building diagnostic model, such as the logistic regression model and Bayes discriminant analysis, diagnosis of ectopic pregnancy becomes more scientific and practical. Meta analysis make evaluation of diagnostic efficiency more precise. With the comparison and optimization of various diagnostic models, We believe that non-invasive diagnosis of ectopic pregnancy has immense application prospects.

1 Barnhart KT, Casanova BC, Sammel MD, et al. Prediction of location of a symptomatic early gestation based solely on clinical presentation[J]. Obstet Gynecol, 2008, 112(6): 1319-1326.
2 Fabio RC, Paula BF, Pedro PP, et al. Serum markers in the diagnosis of tubal pregnancy[J]. Clinics, 2008, 63(5): 701-708.
3 Borrelli PT, Butler SA, Dosherty SM, et al. Human chorionic gonadotropin isoforms in the diagnosis of ectopic pregnancy[J]. Clin Chem,2003,49(2):2045-2049.
4 Lee JK, Oh MJ, Shin JS, et al. Clinical effectiveness of urinary human chorionic gonadotropin related protein (hCGRP) quantification for diagnosis of ectopic pregnancy[J]. Korean Med Sci. 2005, 20(3): 461-467.
5 Dart R, Ramanujam R, Dart L, et al. Progesterone as a predictor of ectopic pregnancy when theultrasound is indeterminate[J]. Am J Emerg Med, 2002, 20(7): 575-579.
6 Felemban A, Sammour A, Tulandi T.Serum vascular endothelial growth factor as a possible marker for early ectopic pregnancy[J]. Hum Reprod, 2002, 17(2): 490-492.
7 Florio P, Severi FM, Bocchi C, et al. Single serum activin a testing to predict ectopic pregnancy [J]. J Clin Endocrinol Metab, 2007, 92(5): 1748-1753.
8 Kirk E, Papageorghiou AT, Van Calster B, et al. The use of serum inhibin A and activin A levels in predicting the outcome of pregnancies of unknown location[J]. Hum Reprod, 2009, 24(10): 2451-2456.
9 Develioglu OH, Aakalli C, Uncu G, et al. Evaluation of serum creatine kinase in ectopic pregnancy with reference to tubal status and histopathology[J]. BJOG, 2002, 109(2): 121-128.
10 Soundravally R, Soundara Raghavan S, Selvaraj N. Serum creatine kinase as a predictor of tubal ectopic pregnancy[J]. Int J Gynaecol Obstet, 2007, 98(3): 253-254.
11 Qin TN, Zhou RX, Liang PH, et al. The value of Fisher discriminant analysis in the diagnosis of ectopic pregnancy[J]. Clin Med China, 2009, 25(7): 765-767. [秦棠妮,周荣向,梁佩洪,等. Fisher判别分析在预测异位妊娠中的价值探讨[J].中国综合临床,2009, 25(7): 765-767.]
12 Mueller MD, Raio L, Spoerri S, et al. Novel placental and nonplacental serum markers in ectopic versus normal intrauterine pregnancy[J]. Fertil Steril, 2004, 81(4): 1106-1111.
13 Xu CJ, Qu W, Lu AW, et al. Diagnostic value of serum markers to earlier ectopic pregnancy[J]. Guizou Med J, 2008, 32 (7): 590-592. [徐春佳,渠魏,陆安伟,等. 联合血清标记物检测对早期异位妊娠的诊断价值[J].贵州医药,2008, 32 (7): 590-592.]
14 Zhang L, Zhang YZ. The application value of measurement serum β-hCG combined P,CK,VEGF for early diagnosis of ectopic pregnancy[J]. J Birth Hered, 2006, 14(3): 87-88. [张玲,张元珍. 血清β-hCG联合P、CK、VEGF在异位妊娠早期诊断中的应用价值[J]. 中国优生与遗传杂志,2006, 14(3): 87-88. ]
15 Gracia CR, Barnhart KT. Diagnosing ectopic pregnancy: Decision analysis comparing six strategies[J]. Obstet Gynecol, 2001, 97(3): 464-470.
16 Seeber B, Sammel M, Zhou L, et al. Endometrial stripe thickness and pregnancy outcome in first-trimester pregnancies with bleeding, pain or both[J]. J Reprod Med, 2007, 52(9): 757-761.
17 Shang YH, Fan YF. The value of differential diagnosis for ectopic pregnancy by transvaginal ultrasonography、serum β-hCG and progesterone[J]. Matern Child Health Care China, 2007, 22(27): 3874-3875. [尚艳红,范银芳. 阴道超声联合血清β-hCG、孕酮检测在早期易误诊的宫内妊娠与异位妊娠鉴别诊断中的价值[J]. 中国妇幼保健,2007, 22(27): 3874-3875.]
18 Chen ZY, Liang WX, Liu JH, et al. The study of early ectopic pregnancy based on logistic regression model[J]. J Chin Phy, 2008, 10(2): 188-190. [陈智毅 ,梁伟翔,柳建华,等. 基于Logistic回归的早期可疑异位妊娠诊断模型的研究[J]. 中国医师杂志,2008, 10(2): 188-190.]
19 Van Calster B, Condous G. An application of methods for the probabilistic three-classclassification of pregnancies of unknown location[J]. Artif Intell Med, 2009, 46(2): 139-154.
20 Wei FB, Su YX, He RZ, et al. Investigation on the value of bayes discriminant analysis in early diagnosis of tubal pregnancy[J]. Guangdong Med J, 2006, 27(11): 1687-1689.[隗伏冰,苏宜香,何锐志,等. Bayes判别分析对输卵管妊娠早期诊断价值的探讨[J]. 广东医学,2006, 27(11): 1687-1689.]
21 Gevaert O, Smet FD, Kirk E,et al. Predicting the outcome of pregnancies of unknown location:Bayesian networks with expert prior information compared to logistic regression[J]. Hum Reprod, 2006, 21(7): 1824-1831.
22 Zeng M, Zhou Z. Ectopic pregnancy diagnosis system of multi-criteria decision-making based on vague sets[J]. Dig Med, 2008, 3(12):11-13. [曾萌,周珍. 基于Vague集多准则决策的异位妊娠诊断系统[J]. 中国数字医学,2008, 3(12):11-13.]
23 Liu YX, Wang JZ, Liu JP, et al. The application of meta analysis in evaluating diagnostic tests[J]. J Health Stat, 2005, 22(11): 16-19. [刘云霞,王洁贞,刘建平,等. Meta分析在诊断试验评价中的作用[J]. 中国卫生统计,2005, 22(1): 16-19. ]
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