生殖激素水平测定对早期先兆流产妊娠预后的判断价值

The diagnostic value of reproductive hormone level in pregnancy outcome of first-trimester threatened abortion

目的探讨生殖激素水平测定对早期先兆流产妊娠预后的判断价值。方法选择30例早期先兆流产患者和30例健康早孕妇(对照组)为研究对象,30例早期先兆流产妊娠患者根据其妊娠结局分为观察Ⅰ、Ⅱ组,每组各15例。使用放射免疫法测定所有受试者的血孕酮(P),绒毛膜促性腺激素(β-HCG),雌激素(E2),卵泡刺激素(FSH),催乳素(PRL)及黄体生成素(LH),并对测定值进行统计分析。结果观察Ⅱ组的血P、β-HCG、E2明显低于对照组,且也明显低于观察Ⅰ组(P<0.01),但其FSH、PRL、LH值与对照组比较,差异无统计学意义(P>0.05)。灵敏度分析显示,P、β-HCG、E2对诊断先兆流产不良预后的灵敏度分别为80.0%,80.0%、100.0%,特异度分别为74.0%,78.0%、83.0%,诊断的总符合率分别为77.0%,79.0%、91.0%。结论测定P、β-HCG、E2对预测早期流产妊娠患者的预后有重要价值,其中以E2最为可靠,值得临床推广。

Objective To discuss the measured value of reproductive hormone level in pregnancy outcome of first- trimester threatened abortion. Methods 30 patients with first-trimester threatened abortion and 30 healthy early pregnant women （the control group） were selected as subjects,and 30 patients with first-trimester threatened abortion were divid- ed into the observation I group （n=15） and the observation Ⅱ group （n=15）.The values of blood progesterone （P）,hu- man chorionic gonadotropin （β-HCG）,estrogen （E2）,folliele-stimulating hormone （FSH）,prolactin （PRL） and luteinizing hormone （LH） in all participants were measured by radioimmunoassay.The measured values were statistically analyzed. Results The values of blood P,β-HCG and E2 in the observation Ⅱ group were remarkably lower than those in the control group and the observation I group （P〈0.01）,but there was no statistical difference of FSH, PRL and LH in the observa- tion 11 group compared with the control group （P〉0.05） .Through sensitivity analysis indicated that tile sensitivity of blood P, β-HCG and E2 in the diagnosis of threatened abortion with a poor outcome was 80.0%,80.0% and 100.0% respectively, the corresponding specificity was 74.0%, 78.0% and 83.0% in turn,the total diagnostic consistent rate was 77.0%, 79.0% and 91.0%. Conclusion Measurement of blood P,β-HCG,E2 has important clinical value in predicting pregnancy outcome of first-trimester threatened abortion.Among them,the value of E2 is most reliable,which is worthy of expansion in clinic.