孕5~8周血清孕酮(P)、β-hCG联合B超对先兆流产患者安胎结局的预测价值

Predictive value of serum progesterone and β-hCG combined with B-ultrasound at 5~8 gestational weeks for prognosis of threatened abortion

目的探讨孕5~8周血清孕酮(P)、β人绒毛促性腺激素(β-hCG)联合B超对先兆流产(TA)患者安胎结局的预测价值。方法选取2019年1月至2020年1月遵义市第一人民医院收治的126例孕5~8周TA患者作为观察组,均予以安胎,根据安胎结局分为安胎成功组(n=80)和安胎失败组(n=46),并选取同期产检的健康孕妇100例作为对照组,检测P、β-hCG水平,使用B超检测卵黄囊直径,采用ROC曲线分析P、β-hCG和卵黄囊直径对TA安胎结局的预测价值,并比较分娩结局。结果观察组孕5~8周P、β-hCG低于对照组,卵黄囊直径高于对照组(P<0.05);安胎成功组孕5~8周P、β-hCG水平高于安胎失败组,卵黄囊直径低于安胎失败组(P<0.05);ROC曲线显示,P、β-hCG联合卵黄囊直径预测TA安胎结局的AUC高于单独检测(P<0.05);两组分娩结局比较差异无统计学意义(P>0.05)。结论孕5~8周血清P、β-hCG联合B超对TA安胎结局的预测价值较高。

Objective To investigate the predictive value of serum progesterone(P) and β-human chorionic gonadotropin(β-HCG) combined with B-ultrasound at 5~8 gestational weeks for prognosis of patients with threatened abortion(TA). Methods 126 patients with TA at 5-8 gestational weeks who were admitted to the First People’s Hospital of Zunyi between January 2019 and January 2020 were selected as the observation group. All patients enrolled were given miscarriage prevention treatment, and were divided into successful miscarriage-prevention group(n = 80) and miscarriageprevention failure group(n = 46). Meanwhile, 100 healthy pregnant women were selected as the control group. Serum P and β-hCG levels were detected. The diameter of yolk sac was measured by B-ultrasound. ROC curve was used to analyze the prognostic value of serum P and β-hCG levels, and yolk sac diameter in patients with TA. Delivery outcomes were comparatively analyzed. Results Serum P and β-HCG levels in the observation group were lower than those in the control group at 5~8 gestational weeks, and the diameter of yolk sac was larger than that of the control group(P < 0.05).Serum P and β-hCG levels in the successful miscarriage-prevention group were higher than those in the miscarriageprevention failure group, and the diameter of yolk sac was smaller(P < 0.05). ROC curve analysis showed that the AUC of serum P and β-hCG combined with Yolk sac diameter for predicting miscarriage-prevention outcomes of patients with TA was higher than that of single index detection(P < 0.05). There were no statistically significant differences in delivery outcomes between the two groups(P > 0.05). Conclusion Serum P and β-hCG combined with B-ultrasound at 5~8 gestational weeks has high prognostic value in patients with TA.