联合监测血清CA-125、β-hCG和孕酮对先兆流产结局的预测价值

Clinical significance of combining serum CA-125,β-hCG and progesterone in prediction outcome of threatened abortion

目的探讨联合监测血清糖类抗原-125(carbohydrate antigen 125,CA-125)、β-人绒毛膜促性腺激素(β-human chorionicgonadotrophin,β-hCG)和孕酮(progesterone,P)对先兆流产结局的临床预测价值。方法选择2011年3月至2012年12月期间在我院产科就医的156例孕早期先兆流产孕妇作为观察对象,按妊娠结局分为继续妊娠组(104例)和难免流产组(52例);另选择88例正常妊娠的孕妇作为对照组。采用化学发光法监测其血清CA-125、β-hCG和P水平,并对结果进行统计学分析。结果两组先兆流产的孕妇血清CA125水平均高于对照组,先兆流产难免流产组孕妇血清CA125水平明显高于继续妊娠组;两组先兆流产的孕妇血清β-hCG和P水平均低于对照组,先兆流产难免流产组孕妇血清β-hCG和P水平均明显低于继续妊娠组。对照组和先兆流产继续妊娠组孕妇间隔48 h血清β-hCG和P水平均呈现上升趋势,且97.7%的对照组、92.3%的继续妊娠组孕妇间隔48 h血清β-hCG水平增幅>60%;而先兆流产难免流产组孕妇间隔48 h血清β-hCG水平仅有21.2%呈现上升趋势,间隔48 h血清P水平均呈下降趋势;78.8%的难免流产组孕妇血清β-hCG和P水平同时下降。结论联合检测孕妇血清CA-125、β-hCG和P水平并动态监测其间隔48 h血清β-hCG和P水平变化趋势,对早期先兆流产的结局预测具有重要价值。

Objective To explore the clinical significance of combine serum CA-125, β-hCG and progesterone in prediction of outcomes of threatened abortion. Methods Clinical data of 156 cases of early monovular pregnancy were divided into two groups： including 104 cases with threatened abortion to pregnancy success （TAPS） and 52 cases with threatened abortion to pregnancy failure （TAPF）. At the same time, 88 normal pregnant women were selected as eontrastive group. Serum CA-125, β-hCG and progesterone level were assayed with Chemiluminescence in all the cases. Results The serum CA-125 level of the inevitable abortion group was significantly higher than that of evitable abortion group or eontrastive group, while the β-hCG and progesterone level were significantly lower than those the other two groups at all times. The β-hCG and progesterone level interval 48 h of evitable abortion group and eontrastive group have a rising trend, growth in serumβ-hCG levels more than 60 in 97.7% of the contrastive group and 92.3% of the evitable abortion group; The β-hCG level interval 48 h of only 21.2% of the inevitable abortion group had a rising trend, progesterone level had a downtrend; The serum β-hCG and progesterone level fell at the same time in 78.8% of the inevitable abortion group. Conclusions Joint monitoring of serum CA-125, β-hCG and progesterone, dynamic monitoringthe variation trend of serum β-hCG and progesterone in 48h has important clinical significance in the early prediction of the prognosis of the threatened abortion.