目的 探讨子宫内膜厚度和肌酸激酶/孕酮比值在异位妊娠早期诊断中的价值.方法 以2006年2月～2009年6月在淄博市妇幼保健院就诊的175例疑似异位妊娠患者为研究对象.经阴道超声测量其子宫内膜厚度,检测血清肌酸激酶、孕酮并计算其比值,随访并进行分析.结果 154例患者资料完整,其中69例确诊为异位妊娠,44例为稽留流产,41例为正常宫内孕.平均子宫内膜厚度:正常宫内孕组大于异位妊娠组和稽留流产组(t分别为17.39、14.23,均P<0.05),但异位妊娠组和稽留流产组比较无显著性差异(P>0.05).肌酸激酶/孕酮比值:异位妊娠组大于正常宫内孕组和稽留流产组(t分别为6.07、6.28,均P<0.05),但正常宫内孕组和稽留流产组比较无显著性差异(P>0.05).联合阴道超声测量子宫内膜厚度,检测肌酸激酶、孕酮并计算其比值的方法诊断异位妊娠的灵敏度、特异度、阳性预测价值、阴性预测价值分别为88.3%、86.6%、91.6%、90.7%.结论 联合子宫内膜厚度及肌酸激酶/孕酮比值对异位妊娠的早期诊断有重要参考价值.%Objective To assess diagnostic value of endometrial thickness measurement and serum creatinekinase/progesterone (CK/P)ratio for diagnosis of ectopic pregnancy (EP). Methods 175 patients with suspected EP who were treated in Zibo Municipal Maternity and Child Health Hospital in a period from February, 2006 to June, 2009 were selected for study. Their endometrial thickness was measured by transvaginal ultrasonography and their serum levels of CK and P were detected and CK/P ratio was calculated for analysis. Results Among 154 patients with complete clinical data of suspected EP, 69 patients were diagnozed as EP ( study group 1 ) ,44 patients had missed abortion( study group 2) and 41 women had normal intrauterine pregnancy (study group 3). The average endometrial thickness measured in study group 3 was thicker than that in study group 1 and study group 2 (t ＝ 17.39, 14.23 respectively, both P ＜ 0.05 ). While there was no significant difference in average endometrial thickness between study group 1 and study group 2 ( P ＞ 0.05 ). The CK/P ratio in study group 1 was significantly higher than the other two groups. ( t ＝ 6.07, 6.28 respectively, both P ＜ 0.05 ), while there was no significant difference between study group 2 and study group 3 ( both P ＞ 0.05 ). The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of measurement of endometrial thickness by transvaginal ultrasonography combined with detection of serum leves of CK and P and their ratio for EP were 88.3％, 86.6％, 91.6％ and 90.7％ respectively. Conclusion Measurement of endometrial thickness by transvaginal ultrasonography combined with CK/P ratio is of significant reference value for early diagnosis of EP.
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