联合检测孕酮、β-HCG及甲状腺激素水平在早期先兆流产中的意义

The significance of combined detection of β-HCG,progesterone with thyroid hormone in early threatened abortion

目的探讨检测早孕期血清人绒毛膜促性腺激素（β-HCG）、孕酮及甲状腺激素水平对早期先兆流产患者妊娠结局的预测价值。方法收集于门诊就诊的停经5~9周,有先兆流产症状的女性200例,根据48 h后复测β-HCG是否倍增分为β-HCG倍增良好组（n=147）和β-HCG倍增不良组（n=53）。根据初测孕酮水平分为3个亚组,a亚组：孕酮水平〈10 ng/ml（n=67）,b亚组：孕酮水平在10~20 ng/ml（n=72）,c亚组：孕酮水平〉20 ng/ml（n=51）。将β-HCG倍增良好组所有患者随机分为黄体酮保胎治疗组及期待观察组。结果β-HCG倍增良好组妊娠成功率与β-HCG倍增不良组比较,差异有统计学意义（P〈0.05）。a亚组妊娠成功率与b、c两个亚组比较,差异有统计学意义（P〈0.05）。并且当β-HCG倍增良好时,3个亚组的妊娠成功率均明显增加。在β-HCG倍增良好、且孕酮水平〈10 ng/ml时,黄体酮保胎治疗组的妊娠成功率为与期待观察组比较,差异有统计学意义（P〈0.05）。结论孕早期β-HCG倍增良好,妊娠成功率较高,并且当孕酮水平〉10 ng/ml并且β-HCG倍增良好时,先兆流产患者妊娠成功率较高。当β-HCG倍增良好,孕酮水平〈10 ng/ml时,对于出现先兆流产症状的病例给予黄体酮保胎治疗,可明显提高妊娠成功率。β-HCG倍增不良时,无论孕酮水平高低,妊娠结局较差。

Objective To explore the significance of combined detection of the levels of beta- HCG,progesterone with thyroid hormone in early threatened abortion,and their effects on pregnancy outcome. Methods Two hundred pregnant women（ duration of pregnancy： 5 ~ 9 weeks） with threatened abortion symptoms who visited clinic service of our hospital were enrolled in the study. Accoding to the results of secondary detection of β-HCG after 48 hours,these patients were divided intoβ-HCG good redouble group（ n = 147） and β-HCG bad redouble group（ n = 53）. According to the levels of progesterone by the first detection,these patients were redivided into three subgroup： subgroup A： progesterone levels 10 ng / ml（ n =67）,subgroup B： progesterone levels： 10 ~ 20 ng / ml（ n = 72）,subgroup C： progesterone levels 20 ng / ml（ n = 51）. The patients inβ-HCG good redouble group were randomly divided into progesterone tocolyis treatment group and observation group. Results There were significant differences in the success rates of pregnancy betweenβ-HCG good redouble group andβ-HCG bad redouble group（ P 〈0. 05）. There were significant differences in the success rates of pregnancy between subgroup A and subgroup B,subgroup C（ P 〈0. 05）. When β-HCG was well redoubled,the success rates of pregnancy in the three subgroups were obviously increased. Moreover,when β-HCG was well redoubled and progesterone levels 10 ng / ml,there were significant differences in the success rates of pregnancy between progesterone tocolyis treatment group and observation group（ P 〈0. 05）. Conclusion The success rates of pregnancy are higher and β-HCG is well redoubled during early gestation,furthermore,whenβ-HCG is well redoubled and progesterone levels 10 ng / ml,the success rates of pregnancy are higher in patients with threatened abortion,besides,at this time,progesterone tocolyis treatment can obviously enhance success rates of pregnancy. In contrast to that,when β-HCG is not well redoubled,the pregnancy outcomes are worse,whether progesterone levels are higher or not.