摘要:
目的 动态分析血清β-人绒毛膜促性腺激素(β-HCG)、孕酮和雌二醇值在鉴别早期正常妊娠、宫内妊娠流产和异位妊娠中的价值.方法 将怀孕30~35 d的106例受检者根据妊娠后果分为3组:正常妊娠(先兆流产继续妊娠)组38例,宫内妊娠流产组33例,异位妊娠组35例,采静脉血测定β-HCG、孕酮、雌二醇的水平,48h后用同法复测三项指标.结果 首测时正常妊娠组三项指标均明显高于妊娠流产组和异位妊娠组,而妊娠流产组和异位妊娠组比较,β-HCG、孕酮、雌二醇差异均无统计学意义.复测β-HCG、孕酮、雌二醇,妊娠流产组孕酮值由(14.8±9.6) mg/L下降为(8.7±5.8) mg/L,下降显著,β-HCG、雌二醇差异无统计学意义;以复测β-HCG每48 h升高>60%为阳性、孕酮=20μg/L为阈值及两者联合分析鉴别正常妊娠和异常妊娠(妊娠流产和异位妊娠),有较好的敏感性、特异性和准确率;以复测β-HCG下降>50%为阳性,孕酮=10μg/L为阈值及两者联合分析鉴别妊娠流产和异位妊娠,有较好的敏感性、特异性和准确率,两者联合分析确诊率更高.结论 动态监测血清β-HCG、孕酮、雌二醇的水平及其升高和下降幅度,对鉴别早期正常妊娠、宫内妊娠流产和异位妊娠有一定的诊断价值.
Abstract:
Objective Dynamic assay of serum β-human chorionic gonadotropin(β-HCG),progesterone and estradiol value,in its analysis to identify early normal intrauterine pregnancy,abortion intrauterine pregnancy and ectopic pregnancy in value.Methods One hundred and six subject of pregnant 30~35 d of the patients were divided into three groups:early normal pregnancy group of 38 cases,early intrauterine pregnancy abortion group of 33 cases,ectopic pregnancy group of 35 cases.Determination to adopt blood β-HCG,progesterone,estradiol levels,48 h with the law after the test of the three indicators.Results β-HCG,progesterone,estradiol of normal pregnancy group were significantly higher than the pregnancy abortion group and ectopic pregnancy group.β-HCG,progesterone,estradiol of pregnancy abortion group and ectopic pregnancy group in 30~35 d was no significant difference.Retest of β-HCG,progesterone,estradiol,pregnancy abortion group progesterone decreased from(14.8±9.6)μg/L to(8.7±5.8)μg/L significantly and β-HCG,estradiol was no significant difference.To β-HCG test every 48 h increased >60%positive and progesterone=20μg/L as the threshold between the two and a joint analysis of three methods to identify normal pregnancy and abnormal pregnancy(ectopic pregnancy and pregnancy abortion),there is a better sensitivity and specificity of diagnosis.In order to test β-HCG decline >50% positive and progesterone=10μg/L as the threshold between the two and a joint analysis of three methods to identify progesterone,estradiol pregnancy abortion and ectopic pregnancy,the better sensitivity and specificity of diagnosis,analysis of both the united confirmed a higher rate.Conclusion Dynamicmonitoring of serum β-HCG, progesterone, estradiol have a certain value in early identification of the normal pregnancy, ectopic pregnancy and intrauterine pregnancy abortions.