血清孕酮、绒毛膜促性腺激素水平预测复发性流产妇女早期流产价值

The value of serum progesterone and HCG levels for predicting early spontaneous abortion in women with recurrent spontaneous abortion

目的:探讨血清孕酮(P)、绒毛膜促性腺激素(HCG)对复发性流产妇女早期流产的预测价值,并分析其与免疫治疗效果关系。方法:回顾性收集2017年5月30日—2018年12月30日在本院行常规产前检查及分娩的孕产妇209例,其中无妊娠早期流产史孕妇125例(正常妊娠组),复发性流产再妊娠孕妇84例(根据本次孕早期是否流产分为流产组35例和未流产组49例)。分析3组孕早期(孕4、6、8、10、12周)P、HCG水平,以及对复发性流产妇女早期妊娠流产的预测价值。对流产组进行免疫治疗,观察P、HCG水平与免疫治疗效果可能关系。结果:复发性流产再妊娠孕妇(流产组和未流产组)自然流产次数及孕次大于正常妊娠组(P<0.05)。孕4、6、8、10、12周HCG水平、P水平流产组最低,未流产组次之,正常妊娠组最高(P<0.05)。ROC曲线显示,孕8周HCG、P水平对复发性流产再妊娠孕妇早期流产具有预测价值(P<0.05),且HCG联合P预测价值更高(AUC=0.81,灵敏度81.5%)。流产组35例接受免疫治疗15例成功,治疗成功组HCG、P水平高于治疗失败组(P<0.05)。结论:孕早期P联合HCG检测预测复发性流产早期妊娠流产的价值较高,且两指标水平与复发性流产妇女免疫治疗效果有关。

Objective:To investigate the value of serum progesterone(P)and HCG levels for predicting early spontaneous abortion of women with recurrent spontaneous abortion(RSA),and to analyze the correlation between P and HCG levels and effect of immunotherapy.Methods:209 pregnant women from May 30,2017 to December 30,2018 were collected retrospectively,which included 125 women without abortion history were in group A and 84 women with RSA were in group B.And in this pregnancy,the women in group B during the first trimester of pregnancy were also divided into 35 women with abortion in group B1 and 49 women without abortion abortion in group B2.The P and HCG levels of women during the first trimester of pregnancy(4,6,8,10,12 gestational weeks)were observed,and the value of P and HCG levels for predicting early pregnancy abortion of women in group B was analyzed.Immunotherapy was performed for the women in group B,and the correlation between P and HCG levels and immunotherapy effect was observed.Results:The number of spontaneous abortion of pregnancy of women in group B were significant higher than those of women in group A(P<0.05).During 4,6,8,10,12 gestational weeks,the HCG or P levels of women in group B1 was the lowest,and that in group A was the highest(P<0.05).ROC curve analysis showed that HCG level or P level of pregnant women during 8 gestational weeks had predictive value for early abortion in group B(P<0.05),and HCG level combined with P level had higher predicted value for early abortion of women with RSA during re-pregnancy(AUC=0.81 and the sensitivity=81.5%).A total of 15 women in group B had successful immunotherapy,and the levels of HCG and P of women in group B2 were significant higher than those women in group B1(P<0.05).Conclusion:The value of P level combined with HCG level of women for predicting the women with RSA is high,both the P level and HCG level are associated with the immunotherapy effects.