血清β-人绒毛膜促性腺激素与孕酮预测早孕不良结局的临床价值

Clinical value of serumβ-HCG and progesterone for predicting early pregnancy adverse outcome

目的探讨血清β-人绒毛膜促性腺激素(β-HCG)及孕酮的动态监测对早孕不良结局的临床价值。方法选取2013年3月至2014年5月于重庆市渝北区妇幼保健院就诊的212例早孕不良结局患者,根据不良结局类型分为先兆流产组(78例)、稽留流产组(65例)、异位妊娠组(69例)。采用化学发光法检测患者初次就诊的血清β-HCG、孕酮水平,并于48h后复查,比较分析各组血清β-HCG水平与倍增时间,以及孕酮水平与分布情况。结果初次及48h后血清β-HCG水平比较,从高到低依次为先兆流产组、稽留流产组、异位妊娠组,其中先兆流产组与稽留流产组和异位妊娠组分别比较差异均有统计学意义(P<0.05)。β-HCG倍增时间比较,从低到高依次为先兆流产组、稽留流产组、异位妊娠组,其中异位妊娠组与先兆流产组和稽留流产组分别比较差异均有统计学意义(P<0.05)。孕酮水平比较,从高到低依次为先兆流产组、稽留流产组、异位妊娠组,其中异位妊娠组初次孕酮水平与先兆流产组和稽留流产组分别比较差异均有统计学意义(P<0.05)。19.23%的先兆流产组患者初次孕酮水平高于79.25nmol/L,无一例低于15.85nmol/L者,而稽留流产组与异位妊娠组初次孕酮水平低于15.85nmol/L者分别占32.31%、44.93%。结论动态监测血清β-HCG与孕酮水平在预测和诊断早孕先兆流产、稽留流产及异位妊娠中具有重要价值。

Objective To investigate the clinical value of dynamic monitoring of serum β- HCG and progesterone levels in predicting the early pregnancy adverse outcome. Methods 212 early pregnant women with adverse out comes in our hospital from Mar. 2013 to May 2014 were selected and divided into the threatened abortion group（78 cases） ,missed abortion group（65 cases） and the ectopic pregnancy group （69 cases） according to the adverse outcome types. The chemiluminiscence method was adopted to detect the serum β-HCG and progesterone levels at the first visiting to hospital, which were re-detected after 48 h. The serum β-HCG and progesterone levels, doubling time, progesterone level and its distribution situation were compared among groups. Results Comparing the serum β-HCG level at the first visiting to hospital and after 48 h, the threatened abortion group：〉the missed abortion group〉 the ectopic gestation group, the differences between the threatened abortion group and the missed abortion group and between threatened abortion group and the eetopie abortion group had statistical significance（P〈0.05）. Comparing the progesterone level,the threatened abortion group 〉 the missed abortion group 〉 the ectopic gestation group, the progesterone level at first visiting in the ectopic gestation group had statistical differences compared with the threat ened abortion group and the missed abortion group（P〈0.05）. The progesterone level at the first visiting in 19.23 % of the patients in the threatened abortion group was higher than 79.25 nmol/L,there was no case of less than 15.85 nmol/L,but the cases of less than 15.85 nmol/L in the missed abortion group and the ectopic gestation group accounted for 32.31% and 44.93 % respectively. Conclusion The dynamical detection of the serum β-HCG and progesterone levels could have an important value in the prediction and diagnosis of threatened abortion, missed abortion and ectopic gestation in early pregnancy.