血清β人绒毛膜促性腺激素、孕激素、可溶性人类白细胞抗原G动态变化在早期先兆流产结局预测中应用研究

Application study of serum β-HCG, P and sHLA-G in predicting the outcome of threatened abortion in early stage

目的探讨血清β人绒毛膜促性腺激素(β-HCG)、孕激素(P)及可溶性人类白细胞抗原G(sHLA-G)动态变化与妊娠结局的关系。方法选取2015年7~12月就诊于长沙市妇幼保健院(以下简称"我院")并要求保胎的先兆流产患者为实验对象,治疗过程中自然流产者34例设为流产组,继续妊娠者106例为妊娠组,同期在我院定期常规产检的正常妊娠孕妇50例为对照组,采用酶联免疫吸附试验于妊娠第5~10周每周一次定量检测体内血清sHLA-G变化值,化学发光法测定其体内血清β-HCG、P水平。结果三组孕妇孕5~10周血清sHLA-G水平比较,差异有统计学意义(P<0.05);流产组与妊娠组孕5~10周血清sHLA-G水平比较,差异有统计学意义(P<0.05)。三组孕妇孕5~10周血清β-HCG水平比较,差异有统计学意义(P<0.05);对照组与妊娠组孕7、8、10周血清β-HCG水平比较,差异有统计学意义(P<0.05);流产组与妊娠组孕7~10周血β-HCG水平比较,差异有统计学意义(P<0.05)。三组孕妇孕5~10周血清孕酮水平比较,差异有统计学意义(P<0.05);对照组与妊娠组孕7~8周血清孕酮水平比较,差异有统计学意义(P<0.05);流产组与妊娠组孕7~10周血清孕酮水平比较,差异有统计学意义(P<0.05)。结论 sHLA-G与β-HCG联合孕酮作为先兆流产结局预测可以提高预测的准确性,减少不必要的治疗,sHLA-G在区分孕5、6周的早早孕先兆流产患者的妊娠结局有特异性。

Objective To investigate the relationship between the dynamic changes of β-HCG, P, sHLA-G and pregnancy outcome. Methods Patients with threatened abortion and tocolytic treatment in Changsha Maternal and Child Health Care Hospital （＂our hospital＂ for short） from July to December 2015 were selected as experimental objects. During the course of treatment, 34 cases of spontaneous abortion were set as abortion group, and 106 cases of pregnancy were set as pregnancy group. At the same time, 50 cases of pregnancy women for regular routine inspection in our hospital were selected as control group. Serum sHLA-G changes were measured quantitatively by enzyme-linked immunosorbent assay （ELISA） at 5 to 10 weeks of gestation. Serum β-HCG and P Levels were detected by chemiluminescence method. Results Serum sHLA-G levels of pregnant women from 5 to 10 weeks among three groups were compared, the differences were statistically significant （P 〈 0.05）. Serum sHLA-G levels of pregnant women from 5 to 10 weeks in abortion group and pregnancy group were compared, the differences were statistically significant （P 〈 0.05）. Serum β-HCG levels of pregnant women from 5 to 10 weeks among three groups were compared, the differences were statistically significant （P 〈 0.05）. Serum β-HCG-levels of pregnant women at 7, 8, 10 weeks between control group and pregnant group were compared, the differences were statistically significant （P 〈 0.05）. Serum [3-HCG levels of pregnant women from 7 to 10 weeks between abortion group and pregnant group were compared, the differences were statistically significant （P 〈 0.05）. Serum P levels of pregnant women from 5 to 10 weeks among three groups were compared, the differences were statistically significant （P 〈 0.05）. Serum P levels of pregnant women from 7 to 8 weeks between control group and pregnant group were compared, the differences were statistically significant （P 〈 0.05）. Serum P levels of pregnant women from 7 to 10 weeks between abortion group and pregnant group were compared, the differences were statistically significant （P 〈 0.05）. Conclusion sHLA-G combined with β-HCG and progesterone as the preadictors of threatened abortion outcome can improve the accuracy of prediction and reduce unnecessary treatment, it is spefic for sHLA-G to distinguish the pregnancy outcome of threatened abortion in early pregnancy of 5, 6 weeks.