动态监测血清孕酮及人绒毛膜促性腺激素对早期异常宫内妊娠的预后判定  

Dynamic monitoring of serum progesterone and human chorionic gonadotropin on prognosis judgment of abnormal early intrauterine pregnancy

作　　者：黄春玉[1] 冯力民[1] 于文[1] 李文君[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科,100050

出　　处：《中国妇产科临床杂志》2014年第5期413-416,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨动态监测血清孕酮(P)及人绒毛膜促性腺激素(β-hCG)对早期异常宫内妊娠的预后进行判定的价值。方法选取2012年1月至2012年12月在首都医科大学附属北京天坛医院妇产科门诊诊治的有阴道出血的早期异常宫内妊娠患者,自就诊之日起动态监测血清P及β-hCG,计算P及β-hCG的变化率,并随访其妊娠结局。结果共有121例患者纳入本研究,按照其妊娠结局的不同分为:先兆流产继续妊娠组(43例)、稽留流产组(37例)、难免流产组(41例)。难免流产组第二次检测的β–hCG及P值均低于第一次检测的结果 (P<0.001);另外两组第二次检测的β–hCG均高于第一次检测的结果 (分别为P=0.006及P<0.001),而P的两次检测结果之间比较差异无统计学意义(分别为P=0.947及P=0.05)。β-hCG的变化率以先兆流产继续妊娠组为最大(与另外两组比较,均为P<0.01),稽留流产组最小(与另外两组比较,均为P<0.01)。P的变化率以难免流产组为最大(与另外两组比较,均为P<0.01),而另外两组P的变化率比较差异无统计学意义(P=0.276)。结论动态监测血清P及β–hCG可以简单、快速的诊断难免流产,而动态监测血清P及β-hCG的变化趋势及变化幅度,可以为临床上鉴别稽留流产及先兆流产继续妊娠的患者提供依据。Objective This study explored the value of dynamic monitoring of blood levels of β- hCG and progesterone on the judgment of abnormal early intrauterine pregnancy. Methods From January 2012 to December 2012, early intrauterine pregnancy patients with abnormal vaginal bleeding who treated in Beijing Tiantan Hospital were enrolled in this study. Serum levels of progesterone and β- hCG were tested. The outcomes of pregnancy of all the patients were under followed up. Results There were 121 cases enrolled in this study. The values of β-hCG and P were significantly decreased in the inevitable abortion group. As in the missed abortion group and threatened abor-tion group, the value of β- hCG was increased and the values of P had no statistically change. The continuing preg nancy group had the greatest change rate of β-hCG, and the missed abortion group had the smallest change rate of - hCG. Inevitable abortion group had the biggest change rate of P. Conclusions Dynamic monitoring of serum pro gesterone and β- hCG is a simple, rapid method to diagnosis inevitable abortion. And evaluating the trends and change rates of β- hCG may help to differentiate missed abortion with continuing pregnancy.

关 键 词：孕酮 Β-HCG 异常宫内妊娠 

分 类 号：R714.21[医药卫生—妇产科学]