人绒毛促性腺激素诊断宫外妊娠部位115例临床分析

The clinical analysis of 115 cases of the location of the ectopic pregnancy by β-HCG

目的探讨人绒毛促性腺激素β亚单位(β-HCG)在宫外妊娠不同部位及不同孕周中的含量,有助于利用β-HCG的含量达到快速诊断宫外妊娠部位的目的。方法健康对照组和正常早孕组各50例于晨7∶00～8∶00抽取空腹静脉血3mL送检,宫外孕患者在急腹症就诊时抽静脉血3mL送检。宫外孕组115例,其中输卵管间质部妊娠13例;输卵管壶腹部妊娠77例;输卵管峡部妊娠25例。年龄17～42岁,平均31岁。β-HCG测定采用电化学发光法测定。结果健康对照组β-HCG为(2.1±0.4)mIU/mL,正常早孕组β-HCG为(36535.16±2563.24)mIU/mL,宫外孕组β-HCG为(4084.82±3936.14)mIU/mL,经统计学处理,健康对照组与宫外孕组比较差异有统计学意义(P<0.01)。输卵管间质部妊娠β-HCG为(3883.13±1379.36)mIU/mL;输卵管壶腹部妊娠β-HCG为(3543.17±3013.00)mIU/mL;输卵管峡部妊娠β-HCG为(2336.46±2103.54)mIU/mL;3组间β-HCG值经统计学处理,差异无统计学意义(P>0.05)。宫外孕患者在4、5、6、7周的β-HCG值分别为(158.59±76.57)mIU/mL、(577.84±176.05)mIU/mL、(1782.63±618.84)mIU/mL、(7731.59±4347.17)mIU/mL,与正常妊娠组在相同孕周比较有统计学意义(P<0.05)。结论正常早孕妇女停经32～65d的β-HCG>10000mIU/mL;宫外孕妇女停经32～65d的β-HCG<10000mIU/mL;可利用β-HCG值诊断是否属宫外孕。研究发现在输卵管间质部妊娠、输卵管壶腹部妊娠及输卵管峡部妊娠组间β-HCG值无统计学意义,不能利用β-HCG确诊其部位。以宫外孕患者β-HCG值比正常妊娠低的特点对快速诊断宫外孕有一定的临床意义。

Objective To discuss Villonodular people gonadotropin β subunit （β-HCG） in different parts of extrauterine pregnancy and gestational age in the different content,to help the use of β-HCG levels to achieve the rapid diagnosis of extrauterine pregnancy purpose of the site. Methods Normal controlled group and normal pregnancy group,50 cases in the morning from 7 to 8：00 censorship 3ml venous blood taken from fasting, ectopic pregnancy when they seek medical treatment in patients with acute abdomen censorship 3ml venous blood pumping. 115 cases of ectopic pregnancy group, one of interstitial pregnancy in 13 cases; 77 cases of tubal pregnancy ampulla; isthmic tubal pregnancy in 25 cases. Age 17-42 years old,average β-year-old. β-HCG was measured by electrochemiluminescence method. Results Normal control group,β-HCG for the （2.1±0.4） mIU/mL,normal pregnancy group of β-HCG for （36 535.16±2 563.24） mIU/mL,ectopic β-HCG for the group （4 084.82 3936.14） mIU/mL,value by the statistical treatment P〈0.01 ,between the normal group and the pregnancy group there was a significant difference. Interstitial pregnancy β-HCG was （3 883. 13±1 379.36） mIU/mL; tubal ampulla β-HCG for pregnancy （3 543. 17±3013.00） mIU/mL; tubal isthmus β-HCG for pregnancy （2336.46±2103.54） mIU/mL ; three groups β-HCG value has been statistically dealed with P〈 0.05, not statistically significant. Ectopic pregnancy in patients after 4,5,6,7 weeks of β-HCG values were （158.59±76.57） mIU/mL, （577.84±176.05） mIU/mL, （1782.63±618.84） mIU/ mL, （7731.59±4347.17） mIU/mL,normal pregnancy and gestational age in the same comparison group have statistical significance （P〈0.05）. Conclusion Menopausal women in early pregnancy normal 32--65 d of β-HCG〉 10 000 mIU/mL; menopausal women with ectopic pregnancy 32-- 65 d of β-HCG 〈10 000 mIU/mL;whether it is a palace outside pregnancy can diagnosis by β-HCG. Study showed that in the interstitial pregnancy, tubal pregnancy and tubal ampullary isthmic pregnancy groups β-HCG value was not significant,and couldn＇t confirmed its position by means of β-HCG and the character of ectopic pregnancy in infertility patients with β-HCG value of weeks of normal pregnancy than low rapid diagnosis of ectopic pregnancy is of some clinical significance.