血清CA125和β-HCG水平对先兆流产的临床意义

Clinical significance of serum CA125 and β-HCG levels in threatened abortion

目的探讨CA125、β-h CG对早期先兆流产的临床意义。方法选取本院先兆流产的120例孕妇作为观察组,依据妊娠结局将观察组分为继续妊娠组与妊娠丢失组,另选取同期100例正常妊娠孕妇作对照组。予观察组隔日肌内注射20 mg黄体酮,隔日肌内注射2 000 u HCG,监测血清CA125、β-HCG水平,治疗时间4 w。120例观察组孕妇中,83例保胎成功,继续妊娠;37例妊娠丢失。于治疗前后采集所有孕妇的清晨空腹肘静脉血4 ml,离心分离血清,应用全自动化学发光分析仪测定血清CA125、β-HCG水平。结果治疗前妊娠丢失组、继续妊娠组血清CA125水平高于对照组(t=8.45,t=24.63,P<0.01),妊娠丢失组与继续妊娠组比较,妊娠丢失组CA125值更高,差异有统计学意义(t=17.12,P<0.01);妊娠丢失组及继续妊娠组的β-HCG水平均显著低于对照组(t=4.34,t=9.29,P<0.01),妊娠丢失组、继续妊娠组2组相比,妊娠丢失组更低,差异有统计学意义(t=7.72,P<0.01)。治疗后妊娠丢失组CA125水平明显高于继续妊娠组与对照组(t=7.85,t=6.43,P<0.01),β-HCG水平明显低于继续妊娠组与对照组(t=8.31,t=7.74,P<0.01),继续妊娠组较治疗前比较两项指标改善明显,与对照组比较差异无统计学意义(P>0.05)。结论联合检测孕妇血清CA125和β-HCG水平有助于诊断先兆流产并预测结局,对指导保胎、及早选用适当的治疗方案有重要临床意义。

Objective To explore the clinical significance of serum CA125 and β-HCG levels in threatened abortion. Methods A total of 120 pregnant women with threatened abortion in our hospital were selected as the observation group,and then divided into the continue pregnant group and the pregnancy loss group. 100 healthy pregnant women during the same period were selected as the control group. The observation group received intramuscular injection of progesterone（20 mg） and HCG（2 000 u） every other day,serum levels of CA125 and β-HCG were monitored for 4 weeks. 83 of the observation group kept the babies successfully while the other 37 failed. Before and after treatment,4 ml of cubital vein fast blood were collected from all the pregnant women,separated by centrifugation,and the serum CA125,β-HCG levels were measured using a full-automatic chemiluminescence analyzer. Results The serum levels of CA125 of pregnancy loss group and continue pregnant group before treatment were significantly higher than those of the control group（t = 8. 45,t = 24. 63,P〈0. 01）. The serum level of CA125 of pregnancy loss group was significantly higher than that of the continue pregnant group（t = 17. 12,P〈0. 01）. The serum levels of β-HCG of pregnancy loss group and continue pregnant group before treatment were significantly lower than those of the control group（t = 4. 34,t =9. 29,P〈0. 01）. The serum level of β-HCG in pregnancy loss group was significantly lower than that in the continue pregnant group（t = 7. 72,P〈0. 01）. After treatment,the serum level of CA125 of pregnancy loss group was significantly higher than that of the continue pregnant group and the control group（t = 7. 85,t = 6. 43,P〈0. 01）. The serum level of β-HCG was significantly lower than that of the continue pregnant group and the control group（t = 8. 31,t = 7. 74,P〈0. 01）. The serum levels of CA125 and β-HCG of continue pregnant group were improved than that before treatment,and the differences were not significant than compared with the control group,with the differences statistically significant（P〈0. 05）. Conclusion Joint test of serum CA125 and β-HCG of pregnant women is helpful for diagnosis and predicting outcomes,which is of great clinical significance to guide the prevention of miscarriage and the early selection of appropriate treatment options.