再次异位妊娠孕妇血清性激素变化及危险因素分析

Analysis of the changes of serum of sex hormone and risk factors of women with recurrent ectopic pregnancy

目的:探讨再次异位妊娠孕妇血清性激素变化及其危险因素。方法:回顾性收集2018年1月—2020年12月本院收治的有异位妊娠流产史孕妇115例,根据本次妊娠结局分组,再次异位妊娠60例为异位妊娠组,正常妊娠住院保胎或分娩55例为正常妊娠组,logistic分析发生再次异位妊娠的可能影响因素。结果:孕6周时,异位妊娠组血清人绒毛膜促性腺激素(HCG)(5314.8±250.2 mIU/ml)及孕酮(P)(31.5±2.6 ng/ml)水平均高于正常妊娠组(1628.0±109.6 mIU/ml、13.8±1.3 ng/ml)(P<0.05)。logistic多项回归分析显示,孕6周HCG水平(>2000 mIU/ml)、包块直径(>4 cm)、重度盆腔粘连及患侧输卵管不通畅是影响妇女再次发生异位妊娠的危险因素(OR>1,P<0.05),而P水平为非危险因素。结论:孕6周血HCG水平(>2000 mIU/ml)、包块直径(>4 cm)、重度盆腔粘连及患侧输卵管不通畅者均是异位妊娠史者再孕发生异位妊娠的危险因素,提示临床应加以关注并采取针对性预防措施,从而降低异位妊娠再次发生。

Objective:To investigate the changes of serum of sex hormone and the risk factors of the women with recurrent ectopic pregnancy.Methods:115 pregnant women with a history of ectopic pregnancy abortion were collected retrospectively.According to the pregnancy outcomes,60 women with the second ectopic pregnancy were in group A,and 55 normal pregnant women were in group B.Logistic analysis was used to analyze the possible influencing factors of the second ectopic pregnancy.Results:The levels of human chorionic gonadotropin(HCG)and progesterone(P)of the women in group A during 6 gestational weeks were 5314.8±250.2 mIU/mL and 31.5±2.6 ng/mL,which were significant higher than those(1628.0±109.6 mIU/mL and 13.8±1.3 ng/ml)of the women in group B(P<0.05).Logistic multiple regression analysis showed that the HCG level>2000 mIU/ml during 6 gestational weeks,the diameter of mass>4cm,the severe pelvic adhesion,and the poor tubal patency of lesion side of the women were the risk factors of their recurrent ectopic pregnancy(OR>1,P<0.05),while the P level of the women was not the risk factors of their recurrent ectopic pregnancy.Conclusion:The HCG level>2000 mIU/ml during 6 gestational weeks,the diameter of mass>4cm,the severe pelvic adhesion,and the poor tubal patency of lesion side of the women were the risk factors of their recurrent ectopic pregnancy,so attention should be paid to and targeted preventive measures should be taken for reducing the recurrence of ectopic pregnancy in clinic.