血清人绒毛膜促性腺激素β亚基、孕酮、甲胎蛋白、肌酸激酶及肌酸激酶/孕酮值在异位妊娠早期诊断中的价值

Determination of serumβ-human chorionic gonadotropin,progesterone,alpha fetoprotein,creatinekinase,and creatinekinase/progesterone for diagnosis of ectopic pregnancy

目的探讨血清人绒毛膜促性腺激素β亚基(β-HCG)、孕酮(P)、甲胎蛋白(AFP)、肌酸激酶(CK)及CK/P在异位妊娠早期诊断中的价值。方法取93例异位妊娠患者(异位妊娠组)和40名宫内早孕妇女(正常早孕组)静脉血,采用化学发光免疫分析法测定血清口β-HCG、P、AFP水平,采用酶动力分析法测定CK水平。结果异位妊娠组的血清β-HCG、P的常用对数值分别为1.69±0.70和1.24±0.33,显著低于正常早孕组的3.10±0.57和1.81±0.18(P值分别<0.05、0.01);异位妊娠组的血清AFP、CK/P的常用对数值分别为0.32±0.24和1.68±0.37,显著高于正常早孕组的0.18±0.32和1.14±0.22(P值均<0.01);异位妊娠组的CK较正常早孕组略有升高,但差异无统计学意义(P>0.05)。结论血清β-HCG、P及CK/P对异位妊娠的早期诊断具有一定价值。

Objective To assess the value of combined determination of 5 serum markers： β-human chorionic gonadotropin （β-HCG）, progesterone （Prog）,alpha fetoprotein （AFP）and creatinekinase （CK）, and CK/ Prog for diagnosis of ectopic pregnancy. Methods Serum contents of β-HCG, Prog,AFP （with chemiluminescent immunoassay） and CK （with enzymatic kinetic method） were determined in 93 patients with suspected early ectopic pregnancy and 40 normal pregnant women. Results The serum levels of lg β-HCG and lg Prog in the ectopic pregnancy group were 1.69 ± 0.70 and 1.24 ±0.33, respectively, which were significantly lower than those in the normal pregnant group, with the levels being 3.10 ± 0.57 and 1.81 ±0.18, respectively （P〈 0.05 or 0.01）. The serum level of lg AFP and lg （CK/Prog） value in the ectopic pregnancy group were 0.32± 0.24 and 1.68±0.37, respectively,which were significantly higher than those in the normal pregnant group, with the levels being 0.18±0.32 and 1.14±0.22, respectively （both P〈0.01）. The serum CK level in the ectopic pregnant group were higher than those in normal pregnant group, but the difference was not significant （P〉0.05）. Conclusion Combined determination of β-HCG, Prog and CK/Prog may contribute to the early diagnosis of ectopic pregnancy.