首次孕酮水平对不良妊娠结局的预测价值研究  

First- Time Serum Progesterone Levels in Predicting the Adverse Outcome of Early Pregnancy

作　　者：黄雅琴[1,2] 郑伟平[1,2] 阮雅文[1,2] 

机构地区：[1]浙江省绍兴市人民医院 [2]浙江大学绍兴医院妇科,312000

出　　处：《中国全科医学》2014年第18期2087-2089,共3页Chinese General Practice

摘　　要：目的：探讨孕早期首次孕酮水平与妊娠结局的关系。方法选取2012年7月-2013年7月浙江省绍兴市人民医院浙江大学绍兴医院妇科门诊收治的年龄18~45岁早孕妇女，其中先兆流产88例、难免流产93例，另随机选取同时期正常早孕妇女88例为对照组。采用化学发光技术检测受检者血清β人绒毛膜促性腺激素（β-HCG）、孕酮、雌二醇水平，运用受试者工作特征（ ROC）曲线确定不良妊娠结局的孕酮水平临界值。结果难免流产组血清β-HCG、孕酮、雌二醇水平较对照组和先兆流产组均减低（ P＜0.01）；对照组与先兆流产组比较，差异均无统计学意义（P＞0.05）。当孕酮取值44.8 nmol/L 时，预测难免流产的敏感度为90.5％，特异度为86.1％，约登指数为0.766。结论难免流产者血清β-HCG、孕酮、雌二醇水平较正常孕妇和先兆流产者均减低，首次孕酮水平低于44.8 nmol/L预示不良妊娠结局。Objective To assess the relationship between the first-time progesterone levels and the outcome of early pregnancy. Methods Women with early pregnancy admitted to the department of gynecology in Shaoxing People＇s Hospital were selected. Among them,88 suffered from threatened abortion and 93 suffered from inevitable abortion. Another 88 women with early pregnancy over the same period were selected as control group. Chemoluminescence method was used to determine the levels ofβ-HCG,progesterone and estradiol. Receiver-operator characteristic（ ROC）curves was used to determine the cut-off point of serum progesterone level in predicting the adverse outcome in early pregnancy. Results The levels of serumβ-HCG,proges-terone and estradiol in inevitable abortion group were significantly lower than those of control group and threatened abortion group （P〈0. 01）,but the control group and threatened abortion group showed no statistically significant difference（P〉0. 05）. The cut-off point of serum progesterone for predicting the adverse outcome in early pregnancy was 44. 8 nmol/L,with a sensitivity of 90. 5% and specificity of 86. 1%,and the Youden＇s index was 0. 766. Conclusion The levels of serumβ-HCG,progesterone and estradiol in inevitable abortion group are significantly lower than those of control group and threatened abortion group. The authors consider that serum progesterone levels lower than 44. 8 nmol/L may be an indicator of adverse pregnancy outcomes.

关 键 词：流产 先兆 妊娠结局 绒毛膜促性腺激素 β亚单位 人 孕酮 雌二醇 

分 类 号：R714.1[医药卫生—妇产科学]