血清β-hCG水平动态变化与滋养细胞侵入输卵管壁深度的相关性研究

An analysis of the correlation between the dynamic changes of serum β-hCG and the depth of trophoblastic infiltration into the tubal wall

目的:研究输卵管妊娠患者血清β-hCG水平动态变化与滋养细胞侵入输卵管壁深度的关联性,为临床治疗输卵管妊娠提供参考。方法:检测110例患侧输卵管切除的输卵管壶腹部妊娠患者术前48 h和手术当天的血清β-hCG水平,术后病理检查确定滋养细胞侵入输卵管壁的深度,采用Kruskal-Wallis H检验进行统计分析。结果:36例Ⅰ期(滋养细胞侵入黏膜层)输卵管妊娠患者48 h血清β-hCG水平平均降低18.35%,32例Ⅱ期(侵入肌层)患者血清β-hCG水平平均升高31.95%,42例Ⅲ期(侵入浆膜层)患者血清β-hCG水平平均升高37.55%,3组间差异具有统计学意义(P<0.05)。Ⅰ期患者β-hCG水平降低幅度低于Ⅱ期和Ⅲ期患者升高幅度,Ⅱ期患者升高幅度低于Ⅲ期患者(P<0.05)。结论:输卵管妊娠患者术前48 h血清β-hCG水平变化程度与滋养细胞侵入输卵管壁深度呈正相关,其可以作为临床上滋养细胞浸润程度判断的一项参考指标。

Objective： To study the correlation between the dynamic changes of serum β-hCG and trophoblast cells invasion depth into the tubal wall in patients with tubal pregnancy in order to provide a reference for the clinical treatment of tubal pregnancy.Methods：110 patients with tubal pregnancy treated in our hospital between April 2013 and April 2014 were recruited; and their serum β-hCG concentrations 48 h and 0 h before the operations, and the results of tests of trophoblast cells invasion depth into the tubal wall were collected.The data was analyzed by H test.Results：On average, among th 36 patients of stageⅠ（ invasive depth to mucous layer） , the level of serumβ-hCG 48 h before the opeprations droped to 18.35%; for stage Ⅱ（ invasive depth to muscle layer） patients the level grows by 31.95%, and for patients of stageⅢ（ invasive depth to serosa） the level growed by 37.55%.The difference was significant among the groups（ P〈0.05） .The reduced degrees of serumβ-hCG in stageⅠpatients were lower than increased degrees in stageⅡand stageⅢpatients, and the increased degrees in stageⅡpatients were lower than in stageⅢpatients（ P〈0.05） .Conclusion：The preoperative change degree of serumβ-hCG is positively correlated with trophoblastic invasion depth into the tubal wall in patients with tubal pregnancy.It could be used as a reference index to judge the extent of trophoblast cell infiltration in clinical practice.