血清β-hCG动态监测药物流产结局的效果

Effect of dynamic monitoring serumβ-hCG level for predicting the outcomes of medical abortion

目的:探讨药物流产后动态监测血清人绒毛膜促性腺激素(β-hCG)预测流产结局的效果。方法:回顾性收集200例停经49d药物流产者临床资料,均于药物流产前、流产后第10天、第20天测定血清β-hCG值,观察其下降率。结果:血清β-hCG水平药物流产前、流产后第10天、流产后第20天,流产不全组均高于流产完全组(均P<0.001);血清β-hCG下降率,流产完全组流产后第10天(94.0±12.0)%、流产后第20天(99.6±12.6)%均高于流产不全组(61.1±8.6)%和(94.1±12.1)%(P=0.001、0.005)。ROC工作曲线分析,当血清β-hCG下降率在药物流产后第10天>93.5%、第20天>97.9%时其流产预后较好。结论:药物流产后动态监测血清β-hCG下降率有望对手术干预提供参考依据。

Objective:To explore the effect of dynamic monitoring serumβ-hCG level of women after medical abortion for predicting abortion outcomes.Methods:The data of pregnant women within 49 gestational days who had experienced medical abortion were analyzed retrospectively.The serumβ-hCG level of all included women were detected before abortion,and on the 10 th and 20 th day after abortion.And the change ofβ-hCG level were observed.Results:The serumβ-hCG level of women with incompleted abortion before abortion,and on the 10 th and 20 th day after abortion were all significant higher than those of women with completed abortion(P<0.001).The descending rate of serumβ-hCG level of women with completed abortion on the 10 th day and 20 th were 94.0±12.0% and 99.6±12.6%,which were all significant higher than those(61.1±8.6%and 94.1±12.1%)of women with uncompleted abortion(P=0.001,0.005).ROC working curve analysis showed that when the decrease rate of serumβ-hCG level was over 93.49% on the 10 th day after abortion,and that was over 97.87%on the 20 th day after abortion,the abortion prognosis could be better.Conclusion:The decrease rate of serumβ-hCG level of women should be dynamically monitored after medical abortion,which is expected to provide a reference for further surgical intervention.