β-HCG、fβ-HCG之倍增率及孕酮水平在不良妊娠中的诊断价值

Expression of abnormal pregnancy in β- HCG,fβ- HCG doubling rate and progesterone levels

目的探讨绒毛膜促性腺激素(β-HCG)及其游离β亚单位(fβ-HCG)含量变化,观测其48 h倍增率,结合孕酮(P)水平在不良妊娠中的诊断价值。方法运用化学发光分析技术检测早期不良妊娠患者的血清β-HCG、游离β-HCG、P水平。根据妊娠情况选择先兆流产组(65例)、稽留流产组(43例)及异位妊娠组(62例),同时以60例正常妊娠孕妇同一指标作为对照。测定各组β-HCG、fβ-HCG和P值,观测其48 h倍增率。结果先兆流产组β-HCG、P水平明显高于稽留流产组和异位妊娠组,fβ-HCG水平明显低于稽留流产组和异位妊娠组(P均<0.05);对照组、先兆流产组、稽留流产组、异位妊娠组48 hβ-HCG倍增率比较,异位妊娠组最低,其次为稽留流产组。稽留流产组、异位妊娠组48 hβ-HCG倍增率显著高于对照组(P<0.05),稽留流产组与异位妊娠组各指标比较无统计学意义(P均>0.05)。结论β-HCG及其48 h倍增率结合P水平,对监测保胎具有重要指导意义,对稽留流产及异位妊娠诊断具有重要参考价值。孕早期48 hβ-HCG倍增率越低,表明β-HCG增长越低,提示流产风险增大。

Objective To investigate the human chorionic gonadotropin（ β- HCG） and its free β- subunit（ fβ- HCG） content change,observe the 48 hours multiplication factor,combined with progesterone（ P） value in the diagnosis of adverse pregnancy for clinical diagnosis and treatment of adverse pregnancy to provide guidance. Methods Using chemiluminescence technique for early detection of adverse pregnancy serum β- HCG,free β- HCG levels,progesterone. According to pregnancy condition,all these cases were divided into threatened abortion group（ 65 cases）,missed abortion group（ 43 cases） and different bit pregnancy group（ 62 cases）,while in 60 cases of normal pregnancy the same indicators were measured and free β- HCG subunit（ fβ- HCG） in the control group. The content observing the 48 hours multiplication factor,referring to progesterone changes,combined with the pregnancy outcomes of the measurement data of each group were analyzed. Results β- HCG,P levels of threatened abortion group were significantly higher than those missed abortion group and ectopic pregnancy group. The fβ- HCG levels were significantly lower than the group missed abortion and ectopic pregnancy group,the difference was statistically significant（ P 〈 0. 05）. The threatened abortion,missed abortion,48 h β- HCG doubling rates in the ectopic pregnancy group was the lowest in the control group,followed by missed abortion group,the difference was significant（ P 〈 0. 05）. Missed abortion,ectopic pregnancy group 48 h β- HCG multiplication rate was significantly higher,the difference was significant（ P 〈 0. 05）. The missed abortion and ectopic pregnancy group,the index was not statistically significant（ P 〉 0. 05）. Conclusion β- HCG and progesterone combined 48 hours multiplication ratio values for monitoring miscarriage of important guiding significance for the diagnosis of missed abortion and ectopic pregnancy has important reference value trimester β- HCG 48 h doubling rate was less than 0. 5. The abortion increased risk; fβ- HCG data descending tips miscarriage treatment is effective.