胚胎移植术后14天妊娠患者血清β-HCG水平对妊娠结局的预测价值  

Serum β-HCG 14 days after embryo transfer in predicting pregnancy outcome

作　　者：徐蓓[1] 朱桂金[1] 章汉旺[1] 艾继辉[1] 李豫峰[1] 靳镭[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院生殖中心,湖北武汉430030

出　　处：《中国实用妇科与产科杂志》2011年第7期534-537,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金资助项目(30901601)

摘　　要：目的评估在胚胎移植(ET)后14d血β-HCG水平对妊娠结局的预测价值。方法选择同济医学院附属同济医院2005-2009年间行ET的2169例病例,比较ET后14d生化妊娠、异位妊娠(Ep)、早期流产(Pa)、正常单胎妊娠(P1)、双胎妊娠(P2)各组的血清β-HCG值。结果 (1)生化妊娠、Ep、Pa、P1、P2组的血清β-HCG平均浓度依次为(61.17±48.14)U/L,(182.21±127.27)U/L,(273.51±177.5)U/L,(532.65±241.32)U/L,(861.69±236.36)U/L,各组间均有明显差异(P<0.05)。(2)生化妊娠,异位妊娠,早期流产,单胎,双胎组血清β-HCG值的主要波动范围分别位于<50U/L,<200U/L,100～500U/L,300～800U/L,>1000U/L。(3)通过ROC曲线分别确定生化妊娠和活胎妊娠、P1和Pa、P1和P2之间的临界点分别为134U/L、375U/L、690U/L。(4)年龄、原发或继发不孕对ET后正常单胎妊娠组血β-HCG值无明显影响;PCOS患者β-HCG值呈最高值,卵巢功能不良和子宫内膜异位症患者β-HCG值最低。除PCOS患者其β-HCG值显著高于男性因素不孕患者(P<0.05),其余各组之间比较差异无统计学意义(P>0.05)。(5)随着β-HCG数值的增加,48h后β-HCG倍增率和正常妊娠率随之增加。结论 ET后14d血β-HCG值是早期预测妊娠结局的良好指标。Objective To assess the clinical value of serum β-HCG assay on day 14 after embryo transfer in predicting pregnancy outcome. Methods We studied 2196 pregnancies after IVF-ET resulting in pregnancy defined as a serum β- HCG concentration on day 14 following embryo transfer during 2005 -2009. Results （ 1 ）The mean β-HCG concentration was （61.17 ±48.14）U/L,（182.21 ± 127.27）U/L, （273.51 ±177.5）U/L, （532.65± 241. 32 ） U/L and （861.69 ± 236. 36 ）U/L in biochemical pregnancy group, Ep, Pa, P1 and P2 group. There were significant differences among them （ P 〈 0.05 ）. （ 2 ） Probabilities of biochemical pregnancy, EP, Pa, P1 and P2 group related to HCG level were given as 〈 50U/L, 〈 200U/L, 100 - 500U/L,300 - 800 U/L and 〉 1000IU/L respectively. （3） The ROC curve suggested an HCG of 134 U/L as the cut -off point to predict biochemical pregnancy and viable pregnancy, 375 U/L to predict PI and Pa, 690 U/L for predicting P2 with high sensitivity and specificity. （4） Among viable singleton pregnancy, age, primary or secondary infertility had no effect on β-HCG level. The median β-HCG level of PCOS patients was higher than male factor significantly（ P 〈 0. 05 ）. There were no significant differences of β-HCG level among other causes. （5） Both doubling rates of β-HCG level at 48 hours and pregnancy rates raised along with the increase of β-HCG level. Conclusions The serum HCG assay on day 14 after embryo transfer is an early marker to predict the pregnancy outcome well.

关 键 词：IVF—ET Β-HCG 妊娠结局 ROC曲线 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]