阴道彩色多普勒血流成像在异位妊娠药物保守治疗中的监测价值  

Monitoring Value of Serumβ-Human Chorionic Gonadotropin and Colour Doppler Flow Imaging in Ectopic Pregnancy With Drug Conservative Treatment

作　　者：王文慧[1] 罗新[2] 

机构地区：[1]中国医科大学北京顺义医院妇产科 [2]暨南大学附属第一医院妇产科

出　　处：《中华妇幼临床医学杂志（电子版）》2010年第6期409-412,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的观察异位妊娠(ectopic pregnancy,EP)药物保守治疗中血清β-人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)值及彩色多普勒血流成像(color Doppler flow imaging,CDFI)的相关性,探讨彩色多普勒血流成像在异位妊娠药物保守治疗转归中的监测价值。方法选择2004年10月至2006年2月在暨南大学附属第一医院妇产科确诊为异位妊娠的90例患者为研究对象。其中,74例采取药物保守治疗(化疗)+强化治疗成功(其中47例为单次保守治疗成功,18例为2～3次保守治疗成功,9例为保守治疗+强化治疗成功),16例为药物保守治疗失败后,行手术治疗成功。对90例患者治疗前、后行彩色多普勒血流成像检查及血清β-人绒毛膜促性腺激素检测。采用测定血清β-人绒毛膜促性腺激素值辅以彩色多普勒血流成像动态检测周围血流信号,观察二者相关性及治疗结局(本研究遵循的程序符合暨南大学附属第一医院人体试验委员会所制定的伦理学标准,得到该委员会批准,并与之签署临床研究知情同意书)。结果治疗前,血清β-人绒毛膜促性腺激素值与附件包块彩色多普勒超声血流信号级别间呈正相关;二者比较,差异有显著意义(P=0.000)。药物保守治疗成功与否,与附件包块彩色多普勒超声血流信号级别有关。结论血清β-人绒毛膜促性腺激素测定和彩色多普勒超声,是检测滋养细胞活力的两项有价值指标。由于血清β-人绒毛膜促性腺激素值变化的特殊性和较长半衰期,在判断即时疗效上,彩色多普勒超声可作为异位妊娠的常规辅助监测手段。Objective To explore correlation of serum β-human chorionic gonadotropin （β-hCG） and color Doppler flow imaging （CDFI） in ectopic pregnancy （EP）, and monitoring value of color Doppler flow imaging in the drug conservative treatment of ectopic pregnancy. Methods From October 2004 to February 2006, 90 ectopic pregnancy patients who were diagnosed in the First Affiliated Hospital of Jinan University were recruited in this study. Among them, 74 patients were received drug conservative treatment （chemotherapy） plus intensification therapy successfully, and 16 were received surgery after the failure of drug conservative treatment. All the cases did serum β-human chorionic gonadotropin and colour Doppler flow imaging before and after drug conservative treatment to observe their correlation. The study protocol was approved by Ethical Review Board of Investigation in Human Being of First Affiliated Hospital of Jinan university. Informed consent was obtained from all participants. Results Before the treatment, positive correlation were found between serum β-human cborionic gonadotropin value and color Doppler flow imaging （P= 0. 000）. The success of conservative treatment was related with color Doppler flow imaging. Conclusion Serum β-human chorionie gonadotropin value and color Doppler flow imaging are two important index to detect trophocyte viability. Beeause of specificity of serum β-human chorionie gonadotropin values and its longer half-life, color Doppler flow imaging could be a routine assistant monitoring method to estimate immediate results of conservative treatment.

关 键 词：异位妊娠 血清β-人绒毛膜促性腺激素 彩色多普勒超声 保守治疗 

分 类 号：R714.22[医药卫生—妇产科学]