经阴道彩色多普勒超声结合血β-HCG对先兆流产结局的评价

Evaluation of threatened abortion prognosis by transvaginal color Doppler ultrasound and serum β-HCG

目的探讨先兆流产孕囊绒毛间隙血流动力学特点,并结合血β-HCG评估先兆流产妊娠的预后。方法经阴道彩色多普勒超声检测孕5~8周32例正常妊娠（A组）和62例先兆流产者,其中继续妊娠（B组）28例,必然流产（C组）34例,在不同孕周时观察其绒毛间隙血流频谱的变化,并测量血β-HCG,对其结果进行分析。结果C组在不同孕周血β-HCG的含量与A、B两组间比较差异有统计学意义（P〈0.05）,A、B两组随孕周的增加血β-HCG的含量升高,而C组的含量开始上升约在第7周下降。A、B两组分别与C组间比较在绒毛间隙血流的收缩期峰值流速（VPS）及收缩期上升支加速度时间（ACT）差异有统计学意义（P〈0.05）,阻力指数（RI）差异有统计学意义（P〈0.01）。结论妊娠8周前随孕周增加血β-HCG减少、绒毛间隙血流RI增加、VPS减小、ACT增加的先兆流产患者无保胎价值,经阴道彩色多普勒超声结合血β-HCG对先兆流产妊娠预后具有较高的指导意义。

Objective To investigate the prognosis of threatened abortion with blood flow dynamics features of intervillous lacuna and changes of serum β- HCG.Methods The intervillous lacuna blood flow spectra changes and serum β- HCG were observed in 32 cases with normal intrauterine pregnancy（A group）and 62 cases with threatened abortion（ 28 cases maintainable pregnancy（B group） and 34 cases inmaintainable pregnancy（C group） different week. The results were analyzed retrospectively. Results There was statistical difference between C group and A or B group in serum β- HCG in various week（ P 〈 0.05） ,with pregnant week increased serum β - HCG of A and B groups raised,however C group serum β - HCG reduced about in the seventh week. There was statistic difference （P〈 0.05）in volume peak systolic（VPS） and accelerate time （ACT） of tomentum rance between A, B group and C group. Conciusion It has no value for tocolysis in patients of threatened abortion whose serum β- HCG ruduce,RI increase, VPS decrease and ACT increase before 8 week, transvaginal color Doppler ultrasound combined with serum β- HCG have important clinical significance for threatened abortion prognosis.