隔日检测血β-HCG在米非司酮治疗异位妊娠结局中的预测价值

The Predictive Value of Serum β-HCG Examination Every Other Day on Treatment of Ectopic Pregnancy with Mifepristone

目的:探讨隔日检测血β-HCG浓度在米非司酮治疗异位妊娠(EP)结局中的预测价值。方法:2005年9月至2008年1月本中心收治早期未破裂型EP患者46例,每日口服米非司酮125～250mg(每片25mg),血β-HCG≤30U/L停药。结果:治愈40例,治愈率为86.96%。平均治疗12.54天,人均用米非司酮71.31片;用药最短3天,服米非司酮18片;用药最长30天,服米非司酮162片。血β-HCG降至正常最短6天,最长30天。初始血β-HCG浓度>隔日血β-HCG的38例全部治愈,隔日血β-HCG浓度>初始血β-HCG的8例仅治愈2例,无效6例,无效率13.04%。结论:药物治疗EP效果与初始血β-HCG浓度高低无主要关系,而与初始血β-HCG与隔日血β-HCG浓度比较有关。只要确定为EP,尤其是隔日血β-HCG>初始血β-HCG的患者,即使血β-HCG浓度较低,也应及时、足量、足疗程药物治疗。

Objective： To study the predictive value of serum β-HCG concentration on every other day in women of ectopic pregnancy treated with mifepristone. Methods：46 cases of EP were diagnosed as unruptured ectopic pregnancy during Sep.2005 - Jan.2008, they were treated with orally mifepristone 125 - 250 mg （25 mg each tablet） per day until serum β-HCG level decrease to below 30 U/L. Results： In these 46 cases, 40 cured. The cure rate was 86.96%. The average treatment duration was 12.54 （3 - 30） days, and mean dosage of mifepristone per person was 71.31 （ 18 - 162） tablets. The duration of serum β-HCG level drops to normal was 6 - 30 days. All 38 cases whose initial serum β-HCG level higher than the every other day were cure completely, however, only 2 of 8 cases whose initial serum β-HCG level lower than the every other day cured, other 6 cases were invalid. Conclusions： The result of medicine therapy of EP has little related with the initial serum β-HCG level, but closely associated with ratio of initial IS-HCG to every other day. Once the diagnosis of EP established, particularly serum β-HCG level on every other day is higher than the initial level, even if serum β-HCG level is low, we should take prompt, sufficient, and full-regimen medicine treatment.