血β人绒毛膜促性腺激素临界值对单剂量和多剂量甲氨蝶呤治疗异位妊娠临床疗效的影响

Effect of β human chorionic gonadotropin cutoff value on single-dose and multi-dose Methotrexate in the treatment of ectopic pregnancy

目的分析血β人绒毛膜促性腺激素(β-hCG)临界值对单剂量和多剂量甲氨蝶呤(MTX)治疗异位妊娠临床疗效的影响。方法选取2014年9月-2018年9月福建医科大学附属泉州第一医院收治的接受MTX治疗的异位妊娠患者150例,根据MTX剂量不同分为单剂量组和多剂量组各75例。比较2组治疗前、治疗后第4天和第7天血β-hCG水平及成功率。结果治疗后第4天和第7天血β-hCG水平均低于治疗前,差异均有统计学意义(P<0.05)。治疗后2组β-hCG水平及血β-hCG达非孕期水平时间比较差异均无统计学意义(P>0.05)。单剂量组治疗成功率为76.0%,多剂量组治疗成功率为81.3%,2组比较差异无统计学意义(χ~2=0.324,P>0.05)。血β-hCG<3 300 mU/ml时,2组治疗成功率比较差异无统计学意义(P>0.05),血β-hCG水平3 300~4 700 mU/ml时,多剂量组治疗成功率高于单剂量组,差异有统计学意义(P<0.05)。结论应用MTX治疗异位妊娠时,初始血β-hCG水平<3300 mU/ml建议采用单剂量方案;初始血β-hCG水平3 300~4 700 mU/ml可采用多剂量方案。

Objective To analysis the effect of blood β human chorionic gonadotropin(β-hCG) on the clinical efficacy of single-dose and multi-dose methotrexate(MTX) in the treatment of ectopic pregnancy. Methods 150 patients with ectopic pregnancy underwent MTX treatment in the First Hospital of Quanzhou Affiliated of Fujian Medical University from September 2014 to September 2018 were selected. According to the dose of MTX, they were divided into single-dose group and multi-dose group. Blood β-hCG levels and success rates were compared between the 2 groups before treatment and on the 4 th and 7 th day after treatment. Results The blood β-hCG levels on the 4 th and 7 th day after treatment were lower than those before treatment, the difference was statistically significant(P<0.05). There were no significant difference in the levels of β-hCG and blood β-hCG between the two groups after treatment(P>0.05). The success rate was 76.0% in the single-dose group and 81.3% in the multi-dose group, there was no significant difference between the two groups(χ~2=0.324,P>0.05). When blood β-hCG<3 300 mU/ml, there was no significant difference in the success rate between the two groups(P>0.05), and the blood β-hCG level was 3 300~4 700 mU/ml, The success rate was higher than the single-dose group, the difference was statistically significant(P<0.05). Conclusion When using MTX to treat ectopic pregnancy, the initial blood β-hCG level<3 300 mU/ml is recommended to use a single dose regimen;the initial blood β-hCG level 3 300~4 700 mU/ml can be multi dose.