血清孕酮及绒毛膜促性腺激素联合检测对妊娠早期结局预测的价值

Clinical values of combined detection of serum progesterone and human chorionic gonadotropin on predicting early pregnancy outcome

目的 探讨在妊娠早期联合检测血清孕酮(P)及48 h绒毛膜促性腺激素(β-HCG)的上升情况对早期妊娠结局的预测价值.方法 采用ECL/RTA技术,将287例孕妇分为正常对照组、先兆流产组、难免流产组、异位妊娠组,研究血清孕酮、48 h β-HCG的上升情况与妊娠结局变化的关系.结果 正常对照组、先兆流产组血清孕酮及β-HCG值明显高于难免流产及异位妊娠组.血清孕酮>20 μg/L者,出现宫内妊娠结局不良及异位妊娠的比例较低;妊娠早期孕酮<10 μg/L者宫内妊娠结局不良及异位妊娠的比例高,组间比较差异有统计学意义(P＜0.05).48 h β-HCG上升理想组比上升不理想组宫内妊娠结局良好比例较高,宫内妊娠结局不良率和异位妊娠率相对较低,差异有统计学意义(P＜0.05).结论 在妊娠早期联合检测血清孕酮及48 h β-HCG上升情况对于妊娠结局的预测及指导治疗具有重要的临床价值.

Objective To investigate the predictive value of the combined detection of serum progesterone (P) and human chorionic gonadotropin (β-HCG) rise in 48 h on early pregnancy outcome.Methods Two hundred and eighty-seven cases of pregnant women were divided into normal control group,threatened abortion group,inevitable abortion group and ectopic pregnancy group. Using the ECL/RTA technology, the relationships of P and pregnancy outcome, β-HCG rise in 48 h and changes of pregnancy outcome were observed. Results P and β-HCG of the normal group and threatened abortion group were significantly higher than other groups. People whose P was greater than 20 μg/L appeared lower adverse intrauterine pregnancy outcome and ectopic pregnancy. People whose P was less than 10 μg/L during early pregnancy appeared higher rate of adverse intrauterine pregnancy outcome and ectopic pregnancy. The differences between the two groups were significant (P<0.05). The group whose 48 h β-HCG increased significantly had higher rate than the one whose 48hβ-HCG rise was not satisfactory in good intrauterine pregnancy outcome. Adverse outcomes of intrauterine pregnancy rate and ectopic pregnancy rate were relatively low. There were significant differences between the two groups (P<0.05) Conclusions During early pregnancy, the combined detection of P and 48 h β-HCG rise had important clinical value in predicting the pregnancy outcome and guiding therapy.