早期β-h CG水平与氨甲蝶呤治疗输卵管妊娠疗效的相关性

Correlation between early β-hCG level and methotrexate in treatment of tubal pregnancy

目的:明确β-绒毛膜促性腺激素(β-hCG)水平与氨甲蝶呤(MTX)治疗4～7 d后治疗效果的相关性。方法:回顾性分析34例输卵管妊娠患者且接受单剂量MTX治疗的临床资料。结果:单剂量MTX治疗有效率为76. 47%(26/34)。在26例MTX治疗有效患者中,7例显示治疗0～4 d后β-hCG水平降低> 15%; 22例(64. 71%)表现出治疗4～7 d后β-hCG水平降低> 15%。对于治疗4～7 d后β-hCG水平降低> 15%患者,RCO曲线下面积是81. 7%,而治疗0～4 d后β-hCG水平降低> 15%患者对应值64. 0%。结论:与治疗0～4 d后比较,治疗4～7 d后β-hCG水平降低>15%能更很好预测单剂量MTX治疗有效。

Objective ： To determine the correlation between β-hCG level after 4-7 days of treatment and the therapeutic effect following methotrexate（MTX） administration. Methods： The clinical data of 34 patients with tubal pregnancy treated with single dose MTX was retrospectively analyzed. Results： The effective rate of single dose MTX was 75% （26/34）. Among 26 patients effectively treated with MTX, 7 cases showed a decrease of more than 15% in β-hCG level after 0-4 days of treatment, and 22（64. 7% ） showed a decrease of more than 15% in β-hCG level after 4-7 days of treatment. The area under the RCO curve was 81.7% for patients whose β-hCG levels decreased by more than 15% after 4-7 days of treatment, and 64. 0% for patients whose β-hCG levels decreased by more than 15% after 0-4 days of treatment. Conclusion： A decrease of β-hCG level of more than 15 % after 4-7 days of treatment is more effective in predicting the efficacy of single-dose MTX than that after 0-4 days of treatment.