血清人绒毛膜促性腺激素对宫外孕患者药物治疗效果的影响

Effects of serum human chorionic gonadotropin level patients with ectopic pregnancy undergoing drug treatment

目的:探讨血清人绒毛膜促性腺激素(β-HCG)水平对宫外孕患者药物治疗效果的影响。方法:回顾性分析2019年1月至2020年12月该院收治的90例宫外孕患者的临床资料,按血清β-hCG水平分为三组,其中低水平组(β-hCG<1500 U/L)31例,中水平组(β-hCG 1500~2500 U/L)30例,高水平组(β-hCG>2500 U/L)29例。三组患者均采用米非司酮联合氨甲蝶呤治疗,比较三组临床疗效和症状缓解时间。结果:三组治疗总有效率比较,差异无统计学意义(P>0.05);低水平组治疗总有效率为87.10%(27/31),高于高水平组的65.52%(19/29),差异有统计学意义(P<0.05);三组腹痛缓解时间、包块消失时间、月经复潮时间、β-hCG转阴时间、孕酮转阴时间比较,差异有统计学意义(P<0.05),且低水平组<中水平组<高水平组,差异均有统计学意义(P<0.05)。结论:低水平β-hCG宫外孕患者以米非司酮联合氨甲蝶呤治疗的效果优于中高水平β-hCG患者。临床针对β-hCG水平较高的患者,可优先考虑非药物治疗方式。

Objective:To investigate effects of serum human chorionic gonadotropin(β-HCG)level patients with ectopic pregnancy undergoing drug treatment.Methods:90 patients with ectopic pregnancy admitted to our hospital from January 2019 to December 2020 were selected for the retrospective analysis.The patients were divided into three groups according to the serumβ-hCG levels,including 31 cases in the low-level group(β-hCG<1500 U/L),middle-level group(β-hCG 1500-2500 U/L),and 29 cases in the high-level group(β-hCG>2500 U/L).Both groups were treated with Mifepristone combined with Methotrexate.The cure rate and the symptom relief time were compared in the three groups.Results:There were no statistical differences in the total effective rate among the three groups(P>0.05).The total effective rate in the low-level group was 87.10%(27/31),which were higher than 65.52%(19/29)in the high-level group,and the difference was statistically significant(P<0.05).There were statistical differences in the abdominal pain relief time,the mass disappearance time,the menstrual recovery time and the time forβ-hCG and progesterone to turn negative among the three groups(P>0.05).The abdominal pain relief time,the mass disappearance time,the menstrual recovery time and the time forβ-hCG and progesterone to turn negative were as follows:the lowlevel group<middle-level group<high-level group,and the differences were statistically significant(P<0.05).Conclusions:The prognosis of the patients with low levelβ-hCG and ectopic pregnancy treated with Mifepristone combined with Methotrexate is better than that of the patients with moderate and high levelβ-hCG.Therefore,for the patients with highβ-hCG level,non-drug treatment can be considered firstly.