妊娠4～9周孕妇血清hCG、E_2水平与先兆流产的相关性分析

Correlation Between Serum hCG and E_2 Levels and Threatened Abortion in Pregnant Women with 4-9 Weeks of Gestation

目的分析妊娠4～9周孕妇血清人绒毛膜促性腺素(hCG)、雌二醇(E_2)水平与先兆流产的相关性。方法回顾性分析我院2015年6月至2017年6月收治妊娠4～9周先兆流产孕妇和正常孕妇临床资料,根据临床资料将146例先兆流产孕妇设为研究组,进一步分成妊娠失败组(n=42)和妊娠成功组(n=104),154例正常孕妇为对照组。比较所有孕妇不同孕周hCG、E_2和孕酮(P)水平变化,同时分析hCG、E_2和P三者串联或并联诊断先兆流产孕妇妊娠结局确诊率。结果三组孕妇血清中hCG和E_2水平均随着孕周增加而逐渐上升,妊娠失败组和妊娠成功组孕妇妊娠4～9周血清hCG和E_2水平均显著低于对照组,三组之间差异具有统计学意义(P <0.05);妊娠失败组,妊娠成功组和对照组孕妇妊娠4～9周血清P水平依次降低,且三组之间差异具有统计学意义(P <0.05);三者联合诊断时,串联诊断时其特异性较高(94. 32%),并联诊断时灵敏度较好(96.53%)。结论妊娠4-9周先兆流产孕妇体内血清hCG、E_2等激素水平下降,其对随后孕妇保胎治疗和妊娠结局预测具有指导意义,值得重点关注。

Objective To analyze the correlation between serum human chorionic gonadotropin(hCG)and estradiol(E2)levels and threatened abortion in pregnant women with 4-9 weeks of gestation.Methods The clinical data of pregnant women with 4-9 weeks of gestation and threatened abortion and normal pregnant women who were admitted to the hospital during the period from June 2015 to June 2017 were retrospectively analyzed.146 pregnant women with threatened abortion(the study group)were divided into the pregnancy failure group(n=42)and the pregnancy success group(n=102),and another 154 normal pregnant women were included in the control group.Changes of hCG,E2 and progesterone(P)levels in different gestational weeks were compared among all pregnant women.The diagnosis rate of pregnancy outcomes in pregnant women with threatened abortion was analyzed by testing hCG,E2 or P alone or the combination of the three.Results The levels of serum hCG and E2 in the three groups increased gradually with gestational age,and the levels of serum hCG and E2 in the pregnancy failure group and the pregnancy success group were significantly lower than those in the control group at 4-9 weeks of gestation,and there were significant differences among the three groups(P <0.05).The P levels in the pregnancy failure group,pregnancy success group and the control group successively decreased at 4-9 weeks of gestation,and there were significant differences among the three groups(P <0.05).The specificity and sensitivity of combined diagnosis of the three markers were high(94.32% as the optimal specificity for the sequential testing,96.53% as the optimal sensitively for the parallel testing).Conclusion The levels of serum hCG and E2 are low in pregnant women with threatened abortion at 4-9 weeks of gestation,which is of guiding significance for the subsequent treatment and prediction of pregnancy outcomes.