人绒毛膜促性激素β亚基和游离雌三醇水平对妊娠并发症和妊娠结局的预测作用

Predictive Effect ofβ-HCG and uE3 on Pregnancy Complications and Pregnancy Outcomes

目的:分析母体血清游离人绒毛膜促性激素β亚基(β-HCG)和游离雌三醇(uE3)水平对妊娠期并发症及妊娠结局的预测作用。方法:选取孕中期孕产妇364例,记录其妊娠期并发症及妊娠结局情况,分为妊娠期并发症组及无妊娠期并发症组、不良妊娠结局组及无不良妊娠结局组,比较各组孕妇孕中期血清游离β-HCG和uE3水平,制作受试者工作特征(ROC)曲线评估血清游离β-HCG、uE3水平与妊娠期并发症及不良妊娠结局的关系。结果:妊娠期并发症组81例(22.25%),未出现妊娠期并发症组283例(77.75%),两组孕妇的年龄、孕次、产次等一般资料比较,差异无统计学意义(P>0.05),妊娠期并发症组孕中期血清游离β-HCG明显高于无妊娠期并发症组(P<0.05),uE3则低于无妊娠期并发症组(P<0.05);不良妊娠结局组28例(7.69%),未出现不良妊娠结局336例(92.31%),两组孕妇年龄、孕次、产次等一般资料比较差异无统计学意义(P>0.05),不良妊娠结局组孕中期血清游离β-HCG明显高于无不良妊娠结局组(P<0.05),uE3则低于无不良妊娠结局组(P<0.05);孕中期血清游离β-HCG、uE3水平对妊娠期并发症及不良妊娠结局均具有较高预测价值(AUC=0.714、0.756、0.958、0.789,P<0.05),其截断值分别为41.085 kU/L、1.155μg/L、52.275 kU/L、1.065μg/L。结论:孕中期血清游离β-HCG及uE3水平可用于预测妊娠期并发症及不良妊娠结局。

Objective:To analyze the predictive effects of maternal serum free human chorionic gonadotropinβsubunit(β-HCG)and uncojugated estriol(uE3)levels on pregnancy complications and pregnancy outcomes.Methods:364 pregnant and lying-in women in the second trimester of pregnancy were selected.The pregnancy complications and pregnancy outcomes were recorded and the patients were divided into pregnancy complication group,non-pregnancy complication group,adverse pregnancy outcome group and non-adverse pregnancy outcome group.The levels of serum freeβ-HCG and uE3 of each group in the second trimester of pregnancy were compared.Receiver operating characteristic curve(ROC curve)was made to evaluate the relationship between serum freeβ-HCG and uE3 levels and pregnancy complications and adverse pregnancy outcomes.Results:Among 364 pregnant and lying-in women,there were 81 cases(22.25%)in the gestational complications group and 283 cases(77.75%)in the non-gestational complications group.There was no statistically significant difference in terms of age,pregnancy and birth rate between the two groups(P>0.05).Serum freeβ-HCG in the second trimester of pregnancy in pregnancy complication group was significantly higher than that in non-pregnancy complication group(P<0.05)while the uE3 level was lower than that in non-pregnancy complication group(P<0.05).Among 364 cases of pregnant and lying-in women,there were 28 cases(7.69%)with adverse pregnancy outcome group,and 336 cases(92.31%)with non-adverse pregnancy outcome group.There was no statistically significant difference in terms of age,pregnancy,and second birth between the two groups(P>0.05).The serum freeβ-HCG in the second trimester of pregnancy in adverse pregnancy outcome group was significantly higher than that in non-adverse pregnancy outcome group(P<0.05)while the uE3 was lower than that in non-adverse pregnancy outcome group(P<0.05).In the second trimester of pregnancy,serum freeβ-HCG and uE3 had higher predictive value on pregnancy complications and adverse pregnancy outcomes(AUC=0.714,0.756,0.958,0.789,P<0.05),and the cutoff values were 41.085 kU/L,1.155μg/L,52.275 kU/L and 1.065μg/L respectively.Conclusion:Serum freeβ-HCG and uE3 in the second trimester can predict pregnancy complications and adverse pregnancy outcomes,and have high clinical application value.