妊娠中期血、尿人绒毛膜促性腺激素水平与不良妊娠结局的关系  

Association of second-trimester maternal serum and urineβ-human chorionic gonadotropin with adverse pregnancy outcome

作　　者：唐龙英[1] 左万兴[1] 陈琪珍[1] 孙廷慰[2] 王天舒[3] 晋华[4] 

机构地区：[1]上海交通大学附属第一人民医院宝山分院妇产科,200940 [2]上海交通大学附属第一人民医院妇产科 [3]上海交通大学附属第一人民医院宝山分院 中心实验室,200940 [4]上海交通大学附属第一人民医院宝山分院 检验科,200940

出　　处：《上海医学》2008年第3期172-174,共3页Shanghai Medical Journal

摘　　要：目的探讨妊娠中期血、尿人绒毛膜促性腺激素(β-HCG)水平与不良妊娠结局(妊娠高血压疾病、早产、胎膜早破)的关系。方法留取709例妊娠中期孕妇的尿样测定β-HCG标准浓度,同时抽取血清测定β-HCG值,随访病史资料至分娩。观察血、尿β-HCG水平与不良妊娠结局的关系。结果709例孕妇中,正常妊娠504名,发生妊娠高血压疾病42例,胎膜早破94例,早产69例。合并妊娠高血压疾病、胎膜早破和早产孕妇的血β-HCG值分别为(2.63±0.42)、(1.90±0.56)和(1.69±0.32)nmol/L,尿β-HCG标准浓度分别为(304.6±54.2)、(256.3±61.7)和(273.5±50.4)ng/mg,均明显高于正常孕妇的(0.88±0.32)nmol/L及(146.3±47.8)ng/mg(P值分别<0.05、0.01)。当孕妇血β-HCG>2倍中位数时,其妊娠高血压疾病、胎膜早破、早产的发生率分别为4.5%、11.2%和5.7%;尿β-HCG>2倍中位数时,分别为5.1%、8.9%和5.4%,均明显高于β-HCG≤2倍中位数孕妇(P值分别<0.05、0.01)。结论妊娠中期血、尿β-HCG水平异常升高是胎盘功能障碍的早期信号,也是发生各种不良妊娠结局的危险信号。测定尿β-HCG较抽取血清更具优越性。Objective To explore the association of second-trimester maternal serum and urine β-human ehorionie gonadotropin （β-HCG） levels with adverse pregnancy outcome including pregnancy-induced hyperten- sion （PIH）, premature rupture of membranes （PROM）, and premature delivery （PD）. Methods Totally 709 women in the second trimester of pregnancy were involved in this study, in whom standardized urine β-HCG concentrations and maternal serum β-HCG level were measured. All the women were followed up till delivery and the association of maternal urine and serum β-HCG levels with adverse pregnancy outcome was analyzed. Results Among the 709 women, 504 had normal pregnancies, 42 developed PIH, 94 experienced PROM and 69 had PD. The serum β-HCG levels were （2.63±0.42）, （1. 90±0.56）, and （1.69±0.32） nmol/L in women with PIH, PROM, and PD, whose urine β-HCG levels were （304.6±54.2）, （256. 3±61. 7）, and （273.5± 50.4） ng/mg, respectively, all significantly higher than the levels in women with normal pregnancy （[0.88± 0.32] nmol/L in the serum and [146.3±47.8] ng/mg in the urine, P〈0. 05,0. 01）. When the maternal serum β-HCG levels exceeded two times of the median levels, the incidences of PIH, PROM and PD were 4. 5%, 11.2%, and 5.7%, respectively; for women with urine β-HCG levels over two times of the median level, the incidences were 5.1%, 8. 9 %, and 5.4 %, respectively, all significantly higher than the incidences in women with β-HCG below two times of the median levels. Conclusion Abnormal elevation of urine and serum β-HCG levels in women in second-trimester pregnancy not only represents an early signal for placenta dysfunction, but also indicates potential adverse pregnancy outcome. Second-trimester maternal urine β-HCG measurement can be superior to serum measurement for clinical assessment.

关 键 词：中期妊娠 绒毛膜促性腺激素 妊娠高血压疾病 胎膜早破 早产 

分 类 号：R714.2[医药卫生—妇产科学]