超声监测黄体血流指数及外周血TPOAb、β-hCG水平对早期先兆流产预后临床意义

Clinical significances of the luteal blood flow index monitored by ultrasound and the levels of peripheral blood anti-thyroid peroxidase antibodies andβ-human chorionic gonadotrophin of women with threatened abortion for predicting their prognosis

目的:探究超声监测黄体血流指数及外周血抗甲状腺过氧化物酶抗体(TPOAb)和人绒毛膜促性腺激素-β(β-hCG)检测对早期先兆流产预后的临床意义。方法:回顾性收集本院2019年5月-2021年1月收治的早期先兆流产孕妇92例为流产组,产前检查健康孕妇92例为对照组,对比两组超声血流灌注指数(PI)、阻力指数(RI)以及外周血TPOAb和β-hCG水平;随访流产组,根据妊娠结局分为预后正常组和预后不良组,对比PI、RI、TPOAb、β-hCG并分析与不良预后关系。结果:流产组PI(0.96±0.14)、RI(2.85±0.53)高于对照组(0.71±0.12、1.75±0.48),血清TPOAb(221.11±1.23 IU/ml)高于对照组(1.89±0.57 IU/ml),β-hCG(46422.85±500.53 mIU/ml)低于对照组(49621.75±513.48 mIU/ml);流产组中,与预后正常孕妇相比,预后不良孕妇PI和RI更高,血清TPOAb水平更高、β-hCG更低(均P<0.05)。pearson回归分析,超声黄体PI、RI以及血清TPOAb和β-hCG与早发型先兆流产预后不良均具有相关性(均P<0.05)。结论:超声监测黄体血流PI和RI及外周血TPOAb,β-hCG,对先兆流产预后有临床指导意义。

Objective:To investigate the clinical significances of the luteal blood flow index monitored by ultrasound,and the levels of peripheral blood anti-thyroid peroxidase antibodies(TPOAb)andβ?human chorionic gonadotrophin(β?hCG)of women with threatened abortion for predicting their prognosis.Methods:92women with early threatened abortion in study group and 92healthy pregnant women in control group from May 2019to January 2021were collected retrospectively.The luteal ultrasonic perfusion index(PI),resistance index(RI),and the levels of peripheral blood TPOAb andβ?hCG of the women were compared between the two groups.The women in the study group were followed up and were divided into group A(women with normal prognosis)and group B(women with poor prognosis)according to the pregnancy outcomes of the women.The values of PI and RI,and the levels of TPOAb andβ?hCG of the women were compared between group A and group B.The correlation between the values of PI and RI,and the levels of TPOAb andβ?hCG of the women and their poor prognosis was analyzed.Results:The values of PI(0.96±0.14)and RI(2.85±0.53)of the women in the study group were significantly higher than those(0.71±0.12and 1.75±0.48)of the women in the control group.The serum TPOAb level(221.11±1.23IU/ml)of the women in the study group was significantly higher than that(1.89±0.57IU/ml)of the women in the control group,but theβ?hCG level(46422.85±500.53mIU/ml)of the women in the study group was significantly lower than that(49621.75±513.48 mIU/ml)of the women in the control group.The values of BPI and RI of the women in group B were significantly higher than those of the women in group A,the serum TPOAb level of the women in group B was significantly higher than that of the women in group A,and theβ?hCG level of the women in group B was significantly lower than that of the women in group A(all P<0.05).Pearson regression analysis showed the PI and RI values by luteal ultrasound and the serum TPOAb andβ?hCG levels of the women with early onset threatened abortion were associated with their poor prognosis(all P<0.05).Conclusion:The luteal blood flow PI and RI values monitored by ultrasound and the peripheral blood TPOAb andβ?hCG levels of the women have clinical significances for their prognosis.