CA125、β-HCG、孕酮对早期先兆流产结局的预测

Combination of Serum CA125,β-HCG and Progesterone for the Prediction of Threatened Abortion

目的:探讨血清癌抗原125(CA125)、人绒毛膜促性腺激素(β-HCG)和孕酮联合监测对先兆流产的预测价值。方法:选择153例孕龄5～12周的单胎孕妇,根据妊娠结局将其分为3组:正常妊娠组64例,先兆流产组52例,难免流产组37例。测定3组血清CA125、孕酮及β-HCG水平。结果:先兆流产组和难免流产组孕妇血清中CA125明显高于正常妊娠组(P<0.05)。难免流产组β-HCG、孕酮明显低于正常妊娠组(P<0.05)。以孕酮<16.8 ng/mL为临界值,预测流产的敏感性、特异性及准确性分别为86.7%、89.8%、90.6%;以CA125值>52.2 U/mL为临界值,预测难免流产的敏感性、特异性及准确性分别为82.4%、83.4%、84.1%,同时以孕酮<16.8 ng/mL及CA1 25>52.2 U/mL为临界值,预测难免流产的敏感性、特异性及准确性分别为79.3%、91.3%、95.4%。结论:对于早期先兆流产的预测,联合监测CA125、β-HCG、血清孕酮及比单项指标的测定预测准确率更高。

Objective：To investigate the predictive value of combination of serum levels of CA125, β-HCG and progesterone for threatened abortion. Methods： A total of 153 cases of early singleton pregnancy （5-12 weeks）were enrolled. Serum levels of CA125,β-HCG and progesterone were detected in all participants. According to the outcome of the pregnancy, the participants were divided into three groups：normal intraute-rine pregnancy group, threatened abortion group and inevitable abortion group. Results： The CA125 levels in threatened abortion group and inevitable abortion group were higher than that of normal intrauterine pregnancy group （P〈0.05）. The serum levels of progesterone and β-HCG were significantly lower than that of normal intrauterine pregnancy group （P〈0.05）. Taking separate serum level of progesterone〈16.8 ng/mL or CA125〉52.2U/mI. as critical values, the sensitivity,specificity and accuracy were 86.7% ,89.8% ,90.6% or 82.4% ,83.4%,84. 1% ,respectively. If serum levels of progesterone〈 16.8 ng/mL and CAl25 〉 52.2 U/mL were combined, the sensitivity, specificity and accuracy were 79.3 % ,91.3%,95.4%, respectively. Conclusions： Combination of serum levels of CA125, progesterone and 13-HCG is more valuable than a single index in the prediction of threatened abortion.