β-HCG、PROG、E2及CA125在先兆流产中的临床检测意义

Clinical significance of β-HCG,PROG,E2 and CA125 in threatened abortion

目的:观察先兆流产孕妇血清人绒毛膜促性腺激素(β-HCG)、孕酮(PROG)、雌二醇(E2)及糖类抗原-125(CA125)水平,探讨其对先兆流产诊断以及妊娠结局的预测价值。方法:选择120例先兆流产孕妇(观察组)和100例健康孕早期孕妇(对照组)为研究对象,随访观察组妊娠结局,根据妊娠结局将观察组分为继续妊娠组和妊娠失败组,所有受试者均检测血清β-HCG、PROG、E2、CA125水平。ROC分析血清β-HCG、PROG、E2、CA125对先兆流产诊断和预后预测价值。结果:观察组血清β-hCG、PROG和E2均低于对照组,差异有统计学意义( P <0.05);观察组CA125 水平高于对照组,差异有统计学意义( P < 0.05)。继续妊娠组β-hCG、PROG、E2水平高于妊娠失败组,差异有统计学意义( P <0.05)。β-HCG、PROG、E2、CA125均具有较高诊断和预测先兆流产的预后价值,其中β-hCG、PROG诊断先兆流产的效能较高,其曲线下面积(AUC)分别为0.872(95%CI:0.768~0.976, P =0.001)、0.869(95%CI:0.765~0.973, P =0.001);β-hCG、E2预测先兆流产妊娠结局的效能较高,AUC分别为0.922(95%CI:0.853~0.991, P =0.001)、0.872(95%CI:0.768~0.977, P =0.001)。结论:血清β-hCG、PROG、E2、CA125水平可用于诊断先兆流产,并有效预测先兆流产患者妊娠结局。

Objective: To observe the serum levels of human chorionic gonadotropin(β-hCG),progesterone(PROG),estradiol(E2) and carbohydrate antigen(CA125) in women with threatened abortion,and to explore their predictive value for the diagnosis of threatened abortion and pregnancy outcomes. Methods: 120 cases of threatened abortion pregnant women(observation group) and 100 cases of healthy early pregnant women(control group) were selected as the research objects.The pregnancy outcome of observation group was followed up.According to the pregnancy outcome,observation group was divided into continuous pregnancy group and pregnancy failure group.Serum levels of β-hCG,PROG,E2 and CA125 were detected in all subjects,and the differences between groups were compared.The diagnostic and prognostic value of serum β-hCG,PROG,E2 and CA125 in threatened abortion was analyzed by ROC. Results: The levels of serum β-hCG,PROG and E2 in the observation group were lower than those in the control group( P <0.05),and the levels of CA125 in the observation group were higher than those in the control group( P <0.05).The levels of β-hCG,PROG and E2 in the continued pregnancy group were higher than those in the failed pregnancy group( P <0.05).β-hCG,PROG,E2 and CA125 all had high value in diagnosis and prediction of threatened abortion.Among them,β-hCG and PROG were more effective in diagnosis of threatened abortion.The area under curve(AUC) was 0.872(95%CI:0.768-0.976, P =0.001),0.869(95%CI:0.765-0.973, P =0.001),and β-hCG and E2 were more effective in predicting pregnancy outcomes of threatened abortion,AUC was 0.922(95%CI:0.853-0.991, P =0.001),0.872(95%CI:0.768-0.977,P=0.001). Conclusion: Serum levels of β-hCG,PROG,E2 and CA125 can be used to diagnose threatened abortion and effectively predict pregnancy outcomes in patients with threatened abortion.