血清P、β-HCG联合检测预测和治疗先兆流产的临床研究

Clinical Study on Joint Detection of Serum Progesterone and β-HCG and Treatment of Threatened Abortion

目的：探讨血清孕酮与B-HCG联合检测在预测早期先兆流产预后及其治疗的临床价值。方法：对340例早期先兆流产患者血清P与B-HCG进行检测，并与追踪到的妊娠结局进行分析。结集：血清P值〉25ng／ml、血β-HCG〉50mIU／ml患者66例占19．4％，经绝对卧床休息，未用药治疗，均胚胎发育正常；血清P值在15．94-25ng／ml、血β-HCG10-50mlU／ml患者170例占50％，经口服黄体酮与HCG针保胎治疗后均胚胎发育正常；血清P值〈15．94ng／ml、血β-HCG〈10mIU／ml患者78例占22．9％，终止妊娠者均可见清除宫内组织物中几乎不见新鲜绒毛并伴有不同程度的陈旧性出血；血清孕酮与β-HCG上升不同步患者26例占7．6%，均最终难免流产。结论：联合检测血清孕酮与β-HCG可以预测先兆流产患者妊娠结局，对于指导治疗具有重要的临床价值，既避免不必要的药物干预及经济负担，又能起到提高保胎治疗的成功率。绒毛膜促性腺激素配伍口服天然黄体酮治疗由黄体功能不全引发的早期先兆流产，均能改善先兆流产患者的预后，且对母儿无不良影响，安全有效。

Objective： To explore the clinical value of joint detection of serum progesterone and β -HCG in prediction of outcomes of early threatened abortion. Methods： The serum levels of progesterone and β -HCG in 340 cases with early threatened abortion were detected, then the pregnancy outcomes were analyzed. Results： There were 66 cases （19.4%） whose serum progesterone〉25 ng/ml and β -HCG〉50 mIU/ml, and the development of fetuses was normal after absolute bed rest and without drug treatment; there were 170 cases （50%） with serum progesterone range within 15.94-25ng/ml and β-HCO range within 10-50 mlU/ml, and the development of fetuses was normal after treatment of progesterone and HCG; there were 78 eases （22.9%） whose serum pmgesterone〈15.94 ng/ml and β-HCG〈10 mlU/ml, and no fresh villi was found in removed intrauterine tissues of cases who terminated pregnancy with old hemorrhage at different degree; 26 cases were found with unsynehronized increase of serum progesterone and HCG, accounting for 7.6%, and finally abortion occurred. Conclusion： Joint detection of serum progesterone and β-HCG can predict the pregnancy outcomes of threatened abortion, which may play an important role in directing treatment, avoid unnecessary drug intervention and economic burden, and increase the success rate of toeolysis.