不同孕期孕妇血清激素水平与妊娠结局的相关性分析  

Analysis on the correlation between serum hormone levels and pregnancy outcome of pregnant women in different stages of pregnancy

作　　者：佟文秀 马冬[2] 张艳梅[1] 耿美丽[1] 姜春阳[3] 李鸥[1] 

机构地区：[1]河北联合大学附属唐山工人医院,河北唐山063000 [2]河北联合大学公共卫生学院 [3]天津市人民医院

出　　处：《中国妇幼保健》2015年第7期997-1001,共5页Maternal and Child Health Care of China

基　　金：河北省自然基金〔H2014105093〕

摘　　要：目的:探讨不同孕期孕妇血清中不同激素水平与妊娠结局的相关性,旨在为血清学联检筛查胎儿发育异常的诊断方法提供依据。方法:采用横断面研究方法,选取唐山工人医院门诊常规孕前检查的孕妇400例,收集不同孕周(早期妊娠100例,中期妊娠200例,晚期妊娠100例)孕妇的外周血,应用全自动化学发光免疫分析仪检测不同孕期孕妇血清中人绒毛膜促性腺激素(hCG)、雌二醇(E2)、孕酮(PROG)、甲胎蛋白(AFP)、游离雌三醇(uE3)、催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)水平,并跟踪妊娠结局,比较不同孕期不同妊娠结局组孕妇血清各激素水平差异性。结果:调查结果显示,400例不同孕期的孕妇中,正常妊娠结局者364例,占91%;早期妊娠的主要不良妊娠结局为流产和胚胎停育,且流产、胚胎停育孕妇血清hCG、PROG、E2水平低于早期正常妊娠孕妇,差异有统计学意义(22 570±6 219、5 997±1 790 vs 89430±19 689,18.36±4.58、10.87±1.42 vs 37.68±12.02,756±153、282±129 vs 1 270±220,P<0.001);胚胎停育孕妇血清h CG、PROG、E2水平低于流产孕妇,差异有统计学意义(5 997±1 790 vs 22 570±6 219,10.87±1.42vs18.36,282±129 vs 756±153,均P<0.05);中期妊娠的主要不良妊娠结局为唐氏综合征,且唐氏综合征孕妇血清h CG水平高于中期正常妊娠孕妇,差异有统计学意义(71 500±13 787 vs 43 720±16 038,P<0.01),血清u E3、AFP水平低于中期正常妊娠孕妇,差异有统计学意义(0.75±0.14 vs 2.94±1.41,21.69±3.29 vs 54.08±23.34,均P<0.05);晚期妊娠的主要不良妊娠结局为妊娠期高血压疾病,且妊娠期高血压疾病孕妇血清h CG、AFP水平高于晚期正常妊娠孕妇,差异有统计学意义(30 700±2 662 vs 25 389±8855,179.33±27.82 vs 104.15±23.10,均P<0.001);不同妊娠期各激素相关性分析中,流产孕妇中血清h CG与PROG呈正相关,r=0.660。结论:妊娠早期血清h CG、PROG、E2水平降低与流产及胚胎停育有关Objective： To explore the correlation between serum hormone levels and pregnancy outcome of pregnant women in different stages of pregnancy, provide a basis for serological joint detection in diagnosis of fetal abnormal development. Methods： A total of 400 pregnant women （100 women during early pregnancy, 200 women during middle pregnancy and 400 women during late pregnancy） receiving routine prenatal examination in outpatient department of the hospital were selected, then a cross - section study was conducted; peripheral blood specimens of the pregnant women were collected; automatic chemiluminescent immunoassay analyzer was used to detect and compare serum levels of human chorionic gonadotropin （ hCG）, estradiol, progesterone, alpha fetoprotein （ AFP）, unconjugated estriol, prolactin （PRL）, luteinizing hormone （LH） and follicle stimulating hormone （FSH） among pregnant women in different stages of pregnancy; the pregnancy outcome was followed up. Results ： Among 400 pregnant women in different stages of pregnancy, 364 pregnant women were found with normal pregnancy outcome, accounting tor 91%. The main adverse pregnancy outcome during early pregnancy included abortion and embryo damage, serum levels of hCG, progesterone and estradiol in pregnant women with abortion and embryo damage were statisticaily significantly lower than those in normal pregnant women （22 570±6 219, 5 997 ±1 790 vs. 89 430 ± 19 689;18.36 ±4. 58, 10. 87 ±1.42 vs. 37.68± 12. 02 ; 756 ±153,282 ±129 vs. 1 270 ±220, P 〈 0. 001 ） ; serum levels of hCG, progesterone and estradiol in pregnant women with embryo damage were statistically significantly lower than those in pregnant women with abortion （ 5 997 ± 1 790 vs. 22 570 v 6 219, 10. 87 ±1.42 .vs. 18.36, 282 ±129 vs. 756 ±153, P 〈 0. 05 ） . The main adverse pregnancy outcome during middle pregnancy included Downg syndrome, serum level of hCG in pregnant women with Downg syndrome was statistically significantly higher than tbat in normal preg

关 键 词：激素水平 HCG E2 PROG AFP UE3 PRL LH FSH 不良妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]