血清人绒毛膜促性腺激素和孕酮水平检测在早期先兆流产诊断中的应用

Application of detection of serum levels of human chorionic gonadotropin and progesterone in diagnosis of early threatened abortion

目的 探讨血清人绒毛膜促性腺激素(HCG)和孕酮水平检测对早期先兆流产的诊断价值。方法 选择2018年2月—2020年3月聊城市第二人民医院妇产科收治的100例孕妇作为研究对象。根据妊娠结局不同,将正常妊娠的50名孕妇纳入正常对照组,早期先兆流产的50例孕妇纳入先兆流产组。使用全自动分析仪,采用电化学发光免疫法检测所有孕妇的血清HCG、孕酮、甲胎蛋白(AFP)、白血病抑制因子(LIF)、雌二醇(E_(2))水平;比较两组上述指标水平的差异,考察对所有产妇妊娠结局的诊断效能。结果 先兆流产组的血清HCG、孕酮、AFP水平均明显低于正常对照组,LIF、E_(2)水平均明显高于正常对照组[HCG(U/L):7 825.32±152.12比10 435.33±154.12,孕酮(nmo/L):25.32±1.32比35.25±1.21,AFP(μg/L):3.72±0.15比10.52±1.11,LIF(ng/L):7.22±1.05比5.44±0.51,E_(2)(ng/L):121.24±20.52比66.32±6.71,均P<0.05]。分析诊断效能结果显示,血清HCG与孕酮联合检测预测先兆流产的准确度明显高于血清HCG和孕酮单独检测(99.0%比95.0%、96.0%),差异均有统计学意义(均P<0.05)。结论 血清HCG和孕酮水平检测能有效预测妊娠结局,判断出早期先兆流产产妇,辅助临床及时采取干预措施,从而改善妊娠结局。此外,AFP、LIF、E_(2)水平检测也可以对早期先兆流产诊断起到辅助作用。

Objective To explore the diagnostic value of serum levels of human chorionic gonadotropin(HCG)and progesterone in early threatened abortion.Methods From February 2018 to March 2020,100 pregnant women admitted to the obstetrics and gynecology department of Liaocheng Second People's Hospital were selected as research objects.According to different pregnancy outcomes,50 pregnant women with normal pregnancy were included in the healthy control group and 50 pregnant women with early threatened abortion were included in the threatened abortion group.The serum levels of HCG,progesterone,Alpha fetoprotein(AFP),leukemia inhibitory factor(LIF)and estradiol(E_(2))were detected by automatic analyzer and electrochemiluminescence immunoassay.The differences of above indexes between the two groups were compared,and the diagnostic efficacy of different indicators for all maternal pregnancy outcomes was investigated.Results The levels of serum HCG,progesterone and AFP in threatened abortion group were significantly lower than those in healthy control group,and the levels of LIF and E_(2) were significantly higher than those in healthy control group[HCG(U/L):7825.32±152.12 vs.10435.33±154.12,progesterone(nmo/L):25.32±1.32 vs.35.25±1.21,AFP(μg/L):3.72±0.15 vs.10.52±1.11,LIF(ng/L):7.22±1.05 vs.5.44±0.51,E_(2)(ng/L):121.24±20.52 vs.66.32±6.71,all P<0.05].The analysis of diagnostic efficacy results showed that the accuracy of combined detection of serum HCG and progesterone in predicting threatened abortion was significantly higher than those of individual detection of serum HCG and progesterone(99.0%vs.95.0%,96.0%),and the differences were statistically significant(both P<0.05).Conclusions The detection of serum levels of HCG and progesterone could effectively predict pregnancy outcomes,identify women with early threatened abortion,and take intervention measures to improve pregnancy outcomes.In addition,AFP,LIF and E_(2) levels could also play auxiliary roles in diagnosis of early threatened abortion.