血清P、PRL联合β-HCG对孕6周~12周先兆流产保胎结局预测价值分析

Predictive value of serum P and PRL combined with β-HCG on the outcomes of threatened abortion at 6-12 weeks of gestation

目的探讨血清孕酮(P)、催乳素(PRL)、β-人绒毛膜促性腺激素(β-HCG)水平对孕6周~12周先兆流产保胎结局的预测作用。方法选取2017年2月至2018年8月浙江省中医院诊治的260例孕6周~12周先兆流产患者和同期进行产检的220例孕6周~12周健康孕妇为研究对象。将260例孕6周~12周先兆流产患者设为患病组,将220例孕6周~12周健康孕妇设为健康组,比较两组成员血清P、PRL和β-HCG水平。患病组患者实施对症治疗,根据保胎结局将其分为成功组和失败组,比较两组患者血清P、PRL和β-HCG水平。采用Logistic回归分析探讨血清P、PRL和β-HCG水平与孕6周~12周先兆流产保胎结局的关系。结果患病组孕<8周、孕8周~9周、孕>10周患者血清P、PRL、β-HCG水平均相应低于健康组成员,其差异均具有统计学意义(均P<0.05);患病组孕<8周、孕8周~9周、孕>10周患者中,保胎成功组患者血清P、PRL、β-HCG水平均高于相应保胎失败组患者(均P<0.05)。经过Logistic回归分析可知,高龄、血清P降低、血清PRL降低、血清β-HCG降低、每天睡眠时间<8h、用药依从性不佳均是先兆流产孕<8周、孕8周~9周、孕>10周先兆流产患者保胎结局失败的危险因素(OR=4.121、4.840、5.942、5.328、4.406、3.931,均P<0.05;OR=3.274、3.838、5.023、4.697、3.931、3.184,均P<0.05;OR=2.646、3.040、3.951、4.063、3.662、2.852,均P<0.05)。结论孕6周~12周先兆流产患者血清P、PRL和β-HCG水平显著低于健康孕妇,且高龄、血清P降低、血清PRL降低、血清β-HCG降低、每天睡眠时间<8h、用药依从性不佳均是其保胎失败的危险因素。

Objective To explore the predictive effect of serum progesterone(P), prolactin(PRL) and β-human chorionic gonadotropin(β-HCG) levels on the outcomes of threatened abortion during 6-12 weeks of pregnancy. Methods 260 cases of threatened abortion at 6-12 weeks of gestation(diseased group) treated in Zhejiang Hospital of Traditional Chinese Medicine from February 2017 to August 2018 and 220 healthy pregnant women at 6-12 weeks of gestation(healthy group) during the same time were selected as the subjects. The serum P, PRL and β-HCG levels were compared between the two groups. Logistic regression analysis was used to explore the relationship between the levels of serum P, PRL and β-hCG and the outcomes of threatened abortion at 6-12 weeks of gestation. Results The serum levels of P, PRL and β-HCG in patients at < 8 weeks, 8-9 weeks and > 10 weeks of gestation in the diseased group were lower than those in the healthy group correspondingly(all P<0.05). The levels of serum P, PRL and β-HCG in women succeed in fetal protection were higher than those failed in fetal protection at < 8 weeks, 8-9 weeks and > 10 weeks of gestation(all P<0.05). Logistic regression analysis showed that older age, lower serum P level, lower serum PRL level, lower serum β-HCG level, daily sleep time < 8 h and poor medication compliance were risk factors for failure of fetal protection(OR=4.121, 4.840, 5.942, 5.328, 4.406, 3.931, all P<0.05;OR=3.274, 3.838, 5.023, 4.697, 3.931, 3. 184, all P<0.05;OR=2.646, 3.040, 3.951, 4.063, 3.662, 2.852, all P<0.05). Conclusions The levels of serum P, PRL and β-HCG in threatened abortion patients at 6-12 weeks of gestation are significantly lower than those in healthy pregnant women. Older age, lower serum P, lower serum PRL, lower serum β-HCG, daily sleep time < 8 h and poor medication compliance are all risk factors for the failure of fetal protection.