孕酮检测在异位妊娠保守治疗中的价值

The Value of Detecting Serum Level of Progesterone for Expectant Treatment of Ectopic Pregnancy

目的:探讨孕酮检测在异位妊娠保守治疗中的价值。方法:异位妊娠患者50例,采用甲氨蝶蛉(MTX)单次肌肉注射,按照保守治疗成功与否分为成功组(34例)及失败组(16例),患者在治疗前、治疗后均采用化学发光法检查β-hCG及孕酮,并对所测结果进行比较分析。结果:成功组孕酮值为(20.13±1.56)nmol/L,而失败组相应值为(40.17±0.97)nmol/L,两者比较差异有统计学意义(t=45.86,P<0.01);在治疗成功组中血清β-hCG下降至标准的5mIU/ml以下的时间是(23.00±2.01)d,血清孕酮下降至5nmol/L时间为(13.81±1.30)d,两者比较差异有统计学意(t=15.84,P<0.001);在治疗成功组中血清β-hCG开始下降距第一次给药时间是(8.05±1.23)d,血清孕酮开始下降距第一次给药时间是(4.54±0.64)d,两者比较差异有统计学意义(t=10.48,P<0.05)。结论:异位妊娠保守治疗成功的患者中血清孕酮降低所需时间较血清β-hCG短,对治疗结局更有预测意义。

Objective：To discuss the value of the detecting serum level of progesterone for expectant treatment of ectopic pregnancy.Method：50 patients suffered from ectopic pregnancy were treated by MTX（intramuscular injection）,34 patients succeeded （successful group） and 16 patient failed （failure group）,the serum level of progesterone and β-hCG were detected by chemiluminometry and compared between two groups by t-test.Result：The level of progesterone in successful group was （20.13±1.56）nmol/L,failure group was （40.17±0.97）nmol/L,the level of progesterone in successful group was lower than failure group, there was statistical difference between the two groups（t =45.86, P 0.01）.The time thatβ-hCG descend to 5 mIU/ml was （23.00±2.01）days,progesterone descend to 5 nmol/L was（13.81±1.30）days in successful group,the latter was shorter than the former,there was statistical difference between the two groups（t =15.84, P 0.01）.The time that β-hCG begin to descend from beginning was （8.05±1.23）days,the time that progesterone begin to descend from beginning was（4.54±0.64） days,the latter was shorter than the former ,there was statistical difference between the two groups（t =10.48, P 0.05）.Conclusions：The time that progesterone begin to descend is shorter than β-hCG in expectant treatment of ectopic pregnancy,it plays an important role in predicating the result of ectopic pregnancy.