血清人绒毛膜促性腺激素联合纤维蛋白原对无症状稽留流产的预测价值

Predictive value of serum human chorionic gonadotropin combined with fibrinogen in asymptomatic missed abortion

目的探讨血清β-人绒毛膜促性腺激素(β-hCG)联合纤维蛋白原(FIB)在预测无症状稽留流产(MA)中的价值。方法收集2020年2月至2023年2月就诊于扬州大学医学院附属淮安市妇幼保健院的70例无症状MA患者作为观察组,收集同期同一医院的50例正常妊娠孕妇作为对照组。检测两组患者β-hCG、雌二醇(E_(2))、黄体酮和FIB水平。绘制受试者工作特征(ROC)曲线分析β-hCG、E_(2)、黄体酮和FIB预测MA的效能。采用Delong检验比较各指标的预测效能。结果与对照组相比,观察组FIB和β-hCG显著升高,E_(2)和黄体酮显著降低。ROC曲线显示,β-hCG、E_(2)、黄体酮和FIB均可预测MA,曲线下面积分别为0.832、0.759、0.757和0.869。四项指标联合预测MA的曲线下面积为0.949,优于单项指标。FIB与β-hCG呈正相关,与E_(2)、黄体酮呈负相关。结论无症状MA患者FIB和β-hCG升高,E_(2)和黄体酮降低。四项指标联合检测可提高MA的预测效能,有助于识别高危人群。

Objective To investigate the value of serumβ-human chorionic gonadotropin(β-hCG)combined with fibrinogen(FIB)in the prediction of asymptomatic missed abortion(MA).Methods A total of 70 asymptomatic MA patients admitted to Huai′an Maternal and Child Health Care Hospital Affiliated to Yangzhou University Medical College from February 2020 to February 2023 were collected as the observation group,and 50 normal pregnant women from the same hospital in the same period were collected as the control group.The levels ofβ-hCG,estradiol(E_(2)),luteinizing hormone and FIB were measured in both groups.The efficacy ofβ-hCG,E_(2),luteinizing hormone and FIB in predicting MA was analyzed by using the receiver operating characteristic(ROC)curve.Delong test was used to compare the predictive efficacy of each index.Results Compared with the control group,FIB andβ-hCG were significantly higher and E_(2)and progesterone were significantly lower in the observation group,and the ROC curves showed thatβ-hCG,E_(2),progesterone and FIB could all predict MA,with the areas under the curves of 0.832,0.759,0.757,and 0.869,respectively,and the area under the curves of the four indexes in combination predicted MA with an area under the curves of 0.949,which was superior to that of the single indexes.FIB was positively correlated withβ-hCG and negatively correlated with E_(2)and progesterone.Conclusions FIB andβ-hCG were increased and E_(2)and progesterone were decreased in asymptomatic MA patients.The combined detection of the four indexes can improve the predictive efficacy and help to identify the high-risk group.