β-hCG、CA125、P及IGF-Ⅱ预测先兆流产结局价值

The value of beta-HCG, CA125, P and IGF-Ⅱ levels for predicting the outcomes of women with threatened abortion

目的:探讨血清β-人绒毛膜促性腺激素(β-hCG)、糖蛋白125(CA125)、孕酮(P)及胰岛素样生长因子-Ⅱ(IGF-Ⅱ)预测先兆流产结局价值。方法:选取本院产科诊断有先兆流产孕妇120例(病例组)、同期正常妊娠孕妇240例(对照组),比较两组孕6~8周时血清β-hCG、CA125、P及IGF-Ⅱ水平,对病例组治疗,根据治疗后妊娠结局分为继续妊娠组、流产组,采用受试者工作曲线(ROC)分析4项指标在预测先兆流产孕妇妊娠结局效能。结果:病例组的血清β-hCG、P及IGF-Ⅱ水平低于对照组,CA125高于对照组(均P<0.05);病例组治疗后继续妊娠妇女血清β-hCG、P及IGF-Ⅱ水平均高于流产组,CA125低于流产组(均P<0.05);绘制ROC曲线,预测先兆流产不良结局β-hCG的灵敏度87.2%、特异度76.4%、AUC值0.825,CA125灵敏度73.3%、特异度65.2%、AUC值0.704,P灵敏度86.8%、特异度为74.0%、AUC值0.821,IGF-Ⅱ灵敏度53.3%、特异度61.4%、AUC值0.579。结论:血清β-hCG、CA125、P及IGF-Ⅱ水平在先兆流产妇女中发生显著变化,且血清β-hCG、CA125、P预测先兆流产不良结局具有一定临床价值。

Objective:To explore the value of the levels of serumβ-human chorionic gonadotropin(β-HCG),glycoprotein 125(CA125),progesterone(P)and insulin like growth factorⅡ(IGF-Ⅱ)for predicting the outcomes of women with threatened abortion.Methods:120 pregnant women with threatened abortion were selected in study group,and 240 normal pregnant women were selected in the control group.The serum levels ofβ-HCG,CA125,P and IGF-Ⅱof women at 68 gestional weeks were compared between the two groups.The women in the study group were further divided study group 1(women with continuing pregnancy)and study group 2(women with abortion)based on outcomes after treatment.The receiver operating curve(ROC)was used to analyze the value of the four indicators for predicting the pregnancy outcomes of all women.Results:The serum levels ofβ-HCG,P and IGF-Ⅱof women in the study group were significant lower than those of women in the control group,but the serum CA125 level was significant higher(P<0.05).After treatment,the serum levels ofβ-HCG,P and IGF-Ⅱof women in the study group 2 were significant lower than those of women in the study group 1,but the serum CA125 level was significant higher(P<0.05).The sensitivity,the specificity,and the area under the curve(AUC)ofβ-HCG level for predicting adverse outcomes was 87.2%,76.4%,and 0.825,respectively.The sensitivity,the specificity,and the AUC of CA125 level for predicting adverse outcomes was 73.3%,65.2%,and 0.704,respectively.The sensitivity,the specificity,and AUC of P level for predicting adverse pregnancy outcomes was 86.8%,74.0%,and 0.821,respectively.The sensitivity,the specificity,and AUC of IGF-Ⅱlevel for predicting adverse outcomes was 53.3%,61.44%,and 0.579,respectively.Conclusion:The levels of serumβ-HCG,CA125,P and IGF-Ⅱof women with threatened abortion change significantly,and the levels of serumβ-HCG,CA125,P have certain clinical value for predicting the adverse pregnancy outcomes of women with threatened abortion.