孕4～12周血清人绒毛膜促性腺激素、雌二醇水平变化情况分析及其预测早期妊娠结局的价值

Analysis of the changes of serum human chorionic gonadotropin and estradiol levels in 4-12 weeks of pregnancy and its value in predicting early pregnancy outcomes

目的分析早孕者(孕4~12周)血清人绒毛膜促性腺激素(HCG)、雌二醇(E2)水平变化情况及其预测早期妊娠结局的价值。方法回顾性分析2017年11月~2018年10月于我院检查的47例早孕者临床资料,根据孕12周超声检查结果分为正常妊娠组(29例)、流产组(13例)、异位妊娠组(5例)。将排卵日设为0 d,将排卵后15~17 d作为首次检查时间,第2次检查间隔2~3 d,第3次检查间隔7 d,第4次检查间隔10 d以上;采用化学发光法测定血清E2、HCG水平。观察三组间隔2~3、7、≥10 d时的HCG及E2水平变化。结果流产组、异位妊娠组不同间隔时间(2~3 d、7 d、≥10 d)的HCG水平低于正常妊娠组,流产组不同间隔时间(2~3 d、7 d、≥10 d)的HCG水平高于异位妊娠组,差异有统计学意义(P<0.05);异位妊娠组的HCG水平呈下降趋势,正常妊娠组、流产组HCG水平呈上升趋势,各组间比较差异有统计学意义(P<0.05);异位妊娠组、流产组不同间隔时间(2~3 d、7 d、≥10 d)的E2水平低于正常妊娠组,异位妊娠组不同间隔时间(2~3 d、7 d、≥10 d)的E2水平高于流产组,差异有统计学意义(P<0.05);正常妊娠组的E2水平呈上升趋势,流产组的E2水平呈下降趋势,异位妊娠组E2水平先上升、后下降,各组间比较差异有统计学意义(P<0.05)。结论动态监测血清HCG及E2水平利于预测早期妊娠结局,可为早期妊娠结局诊治提供指导。

Objective To analyze the changes of serum human chorionic gonadotropin(HCG)and estradiol(E2)levels in early pregnancy women(pregnancy for 4-12 weeks)and the value of predicting early pregnancy outcomes.Methods The clinical data of 47 early pregnant women(4-12 weeks of pregnancy)examined in our hospital from November 2017 to October 2018 were retrospectively analyzed.According to the results of ultrasonic testing during 12-week pregnancy,they were divided into the normal pregnancy group(n=29),the abortion group(n=13),the ectopic pregnancy group(n=5).The ovulation day was set to 0 d,the first examination was 15-17 d after ovulation,the second examination was 2-3 d interval,the third examination was 7 d interval,and the fourth examination was more than 10 d interval.The levels of serum E2 and HCG were determined using chemiluminescence method.The changes of HCG and E2 levels were observed in the three groups at intervals of 2-3 d,7 d and≥10 d.Results The HCG levels in the abortion group and the ectopic pregnancy group at different intervals(2-3 d,7 d,≥10 d)were lower than those in the normal pregnancy group,the HCG levels in the abortion group at different intervals(2-3 d,7 d,≥10 d)were higher than those in the ectopic pregnancy group,the difference was statistically significant(P<0.05).In the ectopic pregnancy group,the HCG level showed a descending trend.However,the HCG levels in the normal pregnancy group and the abortion group displayed an upward trend,which were displayed statistical significance among inter-group comparisons(P<0.05).The level of E2 in the ectopic pregnancy group and the abortion group at different intervals(2-3 d,7 d,≥10 d)were lower than those in the normal pregnancy group,the level of E2 in the ectopic pregnancy group at different interval(2-3 d,7 d,≥10 d)were higher than those in the abortion group,the difference was statistically significant(P<0.05).The level of E2 in the normal pregnancy group showed a rising trend,while descending in the abortion group,but first rising and then descending in the ectopic pregnancy group,which were displayed statistical significance among inter-group comparisons(P<0.05).Conclusion Dynamic monitoring of serum HCG and E2 levels is beneficial to predicting early pregnancy outcomes,and can provide guidance for the diagnosis and treatment of early pregnancy outcomes.