血清孕酮、β-HCG及尿碘水平对早期妊娠先兆流产保胎结局的预测价值

Predictive value of the levels of serum progesterone,β-HCG,and urinary iodine on the fetus outcomes after threatened abortion in early pregnancy

目的探讨血清孕酮、β-人绒毛膜促性腺激素(β-HCG)及尿碘水平对早期妊娠先兆流产保胎结局的预测价值。方法将106例先兆流产孕妇根据妊娠结局分为继续妊娠组(n=79)、妊娠失败组(n=27),同期产检的100名健康孕妇作为健康对照组,先兆流产组孕妇给与常规保胎治疗4周,采集3组孕妇静脉血采用电化学发光免疫法测定血清孕酮、β-HCG水平,采用比色法检测尿碘水平,比较3组孕妇血清孕酮、β-HCG及尿碘水平;采用受试者工作特征(ROC)曲线下面积(AUC)评估血清孕酮、β-HCG及尿碘单独或三者联合检测对先兆流产孕妇妊娠结局的预测效能。结果先兆流产组孕妇血清孕酮、β-HCG及尿碘水平低于健康对照组,妊娠失败组孕妇血清孕酮、β-HCG及尿碘水平低于继续妊娠组,差异有统计学意义有(P<0.001);ROC分析结果显示,血清孕酮、β-HCG及尿碘3项指标联合检测的AUC=0.872,当Youden指数最大时,其灵敏度为86.1%,特异度为88.9%,均高于单一指标检测。结论血清孕酮、β-HCG及尿碘水平对早期妊娠先兆流产孕妇保胎结局具有一定的预测价值,且3项指标联合检测的预测效能更佳。

Objective To investigate predictive value of the levels of serum progesterone,β-human chorionic gonadotropin(β-HCG)and urinary iodine on the fetus outcome of threatened abortion in early pregnancy.Methods A total of 106 pregnant women with threatened abortion were divided into continued pregnancy(n=79)and pregnancy failure groups(n=27)according to pregnancy outcomes.One hundred healthy pregnant women who underwent antenatal check-up during the same period were used as healthy control group.Pregnant women with threatened abortion were given routine fetus protecting treatment for 4 weeks.The venous blood of pregnant women in three groups was collected,and the serum progesterone andβ-HCG levels were determined by electrochemiluminescence immunoassay.Urinary iodine level was detected by colorimetry.The levels of serum progesterone,β-HCG and urinary iodine were compared among three groups.Area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive power of serum progesterone,β-HCG,and urinary iodine alone or in combination in predicting pregnancy outcomes in women with threatened abortion.Results The levels of serum progesterone,β-HCG,and urinary iodine in women with threatened abortion were lower than those in healthy control group(P<0.05),and less in pregnancy failure group than those in continued pregnancy group(P<0.001).ROC analysis showed that the AUC of the combination of serum progesterone,β-HCG,and urine iodine was 0.872.When the Youden index was the largest,ROC sensitivity and specificity were 86.1%and 88.9%,which were higher than those of a single indicator.Conclusion The levels of serum progesterone,β-HCG,and urinary iodine have a certain predictive value for the outcome of fetus protection of women with threatened abortion in early pregnancy.The prediction performance of their combination is better than a single indicator.