血清β-人绒毛膜促性腺激素对确认辅助生育妊娠成功的预测价值  

The predictive value of a single beta human chorionic gonadotropin determination in pregnancies achieved by assisted reproductive technology

作　　者：叶爱青[1] 谢鑫友[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院检验科,杭州310016

出　　处：《上海医学检验杂志》2001年第2期76-78,共3页Shanghai Journal of Medical Laboratory Sciences

摘　　要：目的探讨血清 β-人绒毛膜促性腺激素 (β- h CG)在人类辅助生育 (ART)所获妊娠中能否精确预测妊娠成功与否的价值。方法对 1998年 12月至 2 0 0 0年 2月我院所行的 49个成功周期的体外受精 -胚胎移植 (IVF-ET)进行回顾性分析 ,46例均在胚胎移植后第 14天抽血检测 β- h CG浓度 ,进行统计分析。结果 46个成功周期可行妊娠率为 78.3% (36 /4 6 )。可行妊娠组与非可行妊娠组 β- h CG x± s分别为 (4 72± 45 ) U/L、(89± 2 4) U/L,P<0 .0 5。以 β- h CG浓度 10 0 U/L 作为划分可行妊娠与非可行妊娠的判断限值 ,敏感性 97% ,特异性 80 % ,其阳性预测值为 95 % ,阴性预测值为 89%。在 46例中有 10例为多胎妊娠 ,其 β- h CG为 (6 5 6± 70 ) U/L,显著区别于单胎妊娠[β- h CG(2 88± 2 0 ) U/L]。可行妊娠率随 β- h CG的升高而增加 ,多胎的概率也随之增加。结论血清 β- h CG检测在人类辅助生育所获妊娠中是一个极好的早期预测手段 ,有利于帮助患者夫妇减少顾虑 ,多胎的预测更有助于医生及时了解情况 。Objective To study whether a single serum β-hCG determination in pregnancies achieved by assisted reproductive technologies(ART) can accurately predict pregnancy viability and inviable pregnancies, multiple gestation. Method Fourty-nine consecutive successful ART pregnancies between November 1998 and February 2000 were studied retrospectively. Fourty-six subjects had a serum β-hCG determinetion 14 days after ET were analyzed. Results 36 of the 46(783%) were found to be viable. The mean β-hCG value of the nonviable was(89±24) U/L, the viable was (472±45)U/L,statistically significant differences were found between these two groups, P<005. According to the cut off value of a single β-hCG>100 U/L in distinguishing viable from nonviable pregnancies achieved, the sensitivity was 97%, specificity 80%,the positive predictive value 95%,the negative predictive value 89%. Ten of the 46 were multiple gestations, the mean β-hCG of the multiple gestations [(656±70) U/L] was significantly different from that of the singleton pregnancies [(288±20)U/L].The probability of viable, and furthermore multiple pregnancies increase when the value of β-hCG goes up. Conclusion A single early serum β-hCG determinaton 14 alays after ET is clinically valuable in predicting pregnancy outcome achieved by ART. It will help the gynecologists to take some measurements in timely. Early reassuring tests may reduce anxiety of the couple.

关 键 词：Β-人绒毛膜促性腺激素 辅助生育技术 妊娠 胚胎移植 

分 类 号：Q579.13[生物学—生物化学] R321－33[医药卫生—人体解剖和组织胚胎学]