不同孕周药物流产加清宫后血β-HCG水平的变化

The changes of blood β-HCG after medical abortion plus curettage at 7 to 25 weeks′ gestation

目的:探讨孕7～25周正常妊娠孕妇药物流产加清宫前后血β-HCG的变化规律。方法:将住院要求终止妊娠的160名孕妇按孕周分为A组(孕周≤8周,48例)、B组(12周≥孕周>8周,62例)和C组(25周≥孕周>12周,50例),用同样方法行药物流产加清宫,分别于服药前,服药后第1、2天及流产后第1、7、14、21天测定血β-HCG值。结果:服药前A、B、C3组血β-HCG平均值分别为(95930±22310)mIU/mL、(143640±35730)mIU/mL和(47610±31760)mIU/mL。服药后第2天A、B、C3组血β-HCG分别平均下降6.94%、2.90%、14.25%。流产后第1天3组则分别下降75.38%、68.20%、83.90%。流产后第7天A、B、C3组分别下降99.27%、98.96%、99.46%。流产后第21天3组血β-HCG值均<10mIU/mL。结论:不同孕周其基础β-HCG水平不同,其中孕8～12周时较高。服药后各组β-HCG下降均不明显,流产后第1天下降幅度最大,且基础β-HCG值低者下降幅度大。流产后第7天血β-HCG均缓慢下降,至第21天时β-HCG均降至正常。

Objective To explore the changes of plasma β-human chorionic gonadotropin（β-HCG） concentrations before and after medical abortion plus curettage at 7 to 25 weeks＇ gestation. Methods 160 gravidas who wanted to terminate pregnancies were divided into group A （gestational age ≤8 weeks, n=48）, group B （gestational age 〉 8 but ≤ 12 weeks, n=62）, and group C （gestational age 〉 12 but ≤25 weeks, n=50）. The same medical abortion plus uterine curettage was performed in all the gravidas and plasma β-HCG levels were detected one day before, 24 and 48 hours following use of mifepristone, and at days 1, 7, 14, and 21 after abortion and curettage. Results The average baseline value of β-HCG was （95 930 ± 22 310） mIU/mL in group A, （143 640 ± 35 730） mIU/mL in group B, and （47 610 ± 31 760） mIU/mL in group C. The β-HCG level was decreased by 6.94%, 2.90%, and 14.25% at day 2 after use of mifepristone, by 75.38%, 68.20%, and 83.90% at day 1 after abortion, by 99.72%, 98.96%, and 99.46% at day 7, respectively. It declined to less than 10 mIU/mL in all groups at day 21. Conclusions The baseline levels of β-HCG are different at different gestational ages, with a high level at 8 to 12 weeks＇ gestation. No significant decrease in β-HCG levels occurs after use of mifepristone. The amplitude of decline in β-HCG is greatest at day 1 after medical abortion, the lower the baseline, the greater the amplitude of decline. β-HCG level decreases slowly from day 7 and returns to normal at day 21.