β-hCG和孕酮在早孕、早期输卵管妊娠和早期先兆流产诊断中的意义

The Significance ofβ-hCG and Progesterone in the Diagnosis of Early Pregnancy,Early Tubal Ectopic Pregnancy and Early Threatened Abortion

目的研究β-人绒毛膜促性腺激素(β-hCG)和孕酮(P)在早孕、早期输卵管妊娠和早期先兆流产诊断中的临床意义。方法回顾分析2022年1月-12月在我院诊治的早孕(23例)、早期输卵管妊娠(40例)和早期先兆流产者(39例)的临床资料,比较不同患者血清β-hCG、P水平,分析血清β-hCG和P单独检测与两者联合检测对早期输卵管妊娠和早期先兆流产的诊断效能(准确度、敏感度、特异度)以及不同妊娠结局早期先兆流产者血清β-hCG和P水平。结果早孕者血清β-hCG、P水平高于早期输卵管妊娠、早期先兆流产者,且早期先兆流产者血清β-hCG、P水平高于早期输卵管妊娠者(P<0.05);血清β-hCG、P联合诊断早期输卵管妊娠和早期先兆流产的准确度、敏感度、特异度均高于血清β-hCG、P单独检测(P<0.05);血清β-hCG检测与P检测诊断早期输卵管妊娠的敏感度、准确度比较,差异无统计学意义(P>0.05),血清β-hCG检测诊断早期输卵管妊娠的特异度小于P检测(P<0.05);血清β-hCG检测与P检测诊断早期先兆流产的敏感度、特异度、准确度比较,差异无统计学意义(P>0.05);自然流产者血清β-hCG、P水平均低于继续妊娠者(P<0.05)。结论血清β-hCG和孕酮在早孕、早期输卵管妊娠和早期先兆流产诊断中具有重要的作用,可作为鉴别诊断指标,尤其是血清β-hCG、P联合检测可提高早期输卵管妊娠和先兆流产诊断准确度和敏感度,并且可作为早期先兆流产者妊娠结局的预测指标,从而为临床医生有效干预提供可靠的参考。

Objective To study the clinical significance ofβ-human chorionic gonadotropin(β-hCG)and progesterone(P)in the diagnosis of early pregnancy,early tubal ectopic pregnancy and early threatened abortion.Methods The clinical data of early pregnancy(23 patients),early tubal ectopic pregnancy(40 patients)and early threatened abortion(39 patients)diagnosed and treated in our hospital from January to December 2022 were retrospectively analyzed.The levels of serumβ-hCG and P in different patients were compared.The diagnostic efficacy(accuracy,sensitivity,specificity)of serumβ-hCG and P alone and combined detection of serumβ-hCG and P in early tubal ectopic pregnancy and early threatened abortion,while serumβ-hCG and P levels in early threatened abortion patients with different pregnancy outcomes were analyzed.Results The levels of serumβ-hCG and P in early pregnancy were higher than those in early tubal ectopic pregnancy and early threatened abortion,and the levels of serumβ-hCG and P in early threatened abortion were higher than those in early tubal ectopic pregnancy(P<0.05).The accuracy,sensitivity and specificity of combined detection of serumβ-hCG and P in the diagnosis of early tubal ectopic pregnancy and early threatened abortion were higher than those of serumβ-hCG and P alone(P<0.05).There was no significant difference in the sensitivity and accuracy of serumβ-hCG detection and P detection in the diagnosis of early tubal pregnancy(P>0.05).The specificity of serumβ-hCG detection in the diagnosis of early tubal ectopic pregnancy was lower than that of P detection(P<0.05).There was no significant difference in the sensitivity,specificity and accuracy of serumβ-hCG detection and P detection in the diagnosis of early threatened abortion(P>0.05).The levels of serumβ-hCG and P in patients with spontaneous abortion were lower than those in patients with continuous pregnancy(P<0.05).Conclusion Serumβ-hCG and progesterone play an important role in the diagnosis of early pregnancy,early tubal ectopic pregnancy and early threatened abortion,and can be used as differential diagnostic indicators.In particular,the combined detection of serumβ-hCG and P can improve the accuracy and sensitivity of early tubal ectopic pregnancy and threatened abortion,and can be used as a predictor of pregnancy outcome in patients with early threatened abortion,so as to provide a reliable reference for clinicians to effectively intervene.