β-hCG、孕酮、CA125结合子宫内膜厚度测定对早期不明位置妊娠的预测价值

Detection of serum β-hCG, progesterone and CA 125 levels combined with measurement of endometrial stripe thickness in predicting the outcome of pregnancies of unknown location.

目的 本研究旨在评价人绒毛膜促性腺激素（β-hCG）、孕酮（P）、CA125结合子宫内膜厚度（EST）测定对早期不明位置妊娠（PUL）的预测价值.方法 收集被诊断为PUL的114例早期停经患者,分别于就诊当天抽血检测β-hCG、P及CA125水平,并经阴道超声（TVS）检测EST,48h后再次抽血检测β-hCG,以诊断准确率、敏感性和特异性来评价各种指标组合预测PUL结局的有效性.结果 114例患者中,84例确诊为异位妊娠（EP）,14例为宫内妊娠（IUP）,10例为先兆流产（IUPM）,6例为难免流产.β-hCG预测PUL结局的诊断准确率最高（86.8%）,β-hCG＋P＋CA125＋EST（三者符合）次之（84.2%）.在诊断EP方面,β-hCG的灵敏度最高（90.5%）,β-hCG＋P＋CA125＋EST（三者符合）次之（82.1%）,β-hCG＋P＋CA125＋EST（三者符合）特异度最高（86.7%）.结论 β-hCG 、P、CA125及EST 4个指标结合使用具有较好的敏感性和特异性,可作为今后预测PUL结局的简便方法.

Objective To evaluate detection of serum β-hCG, progesterone （P）, maternal serum cancer antigen 125 （CA125） levels combined with measurement of endometrial stripe thickness （EST） levels in predicting the outcome of pregnancies of unknown Iocation（PUL）. Methods One hundred and fourteen Women classified as PUL were recruited in this prospective study. Serum β-hCG, P and CA125 levels were measured at 0 h, and EST were examined by trans-vaginal ultrasonography （TVS）. Serum β-hCG were measured again after 48h. We incorporated combinations of variables to predict all outcomes. The prediction of various combinations was evaluated using diagnose accordance rate, sensitivity and specificity. Results In all patients 84 were diagnosed as ectopic pregnancy （EP）, 14 as intrauterine pregnancy （IUP）, 10 as IUPM and 6 as inevitable abortions., diagnose accordance rate of β-hCG in predicting the outcome of PUL was the highest （86.8%）, that of β-hCG＋P＋CA125＋EST was the second （84.2%）. In diagnosing EP, sensitivity of β-hCG was the highest （90.5%）, and that of β-hCG＋P＋CA125＋EST was the second of all （82.1%）. The specificity of β-hCG＋P＋CA125＋EST （86.7%） was the highest among all combinations. Conclusion combinations of β-hCG, P, CA125 and EST have better sensitivity and specificity, and can be used to predict the outcome of pregnancies of unknown location.