联合检测血清β-HCG、雌二醇、孕酮及抗心磷脂抗体预测先兆流产妊娠结局  

Study on combined detection of serum β-HCG, estradiol, progesterone and antiphospholipid antibodies in predicting the outcome of threatened abortion in early pregnancy

作　　者：夏书琴[1] 马宏生[1] 王维琴[1] 贾海琴[2] 刘举珍[2] 

机构地区：[1]内蒙古自治区医院妇产科,内蒙古自治区,呼和浩特010017 [2]内蒙古自治区医院检验科,内蒙古自治区,呼和浩特010017

出　　处：《中国基层医药》2015年第3期321-323,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：内蒙古自治区自然科学基金项目（2011MS1147）

摘　　要：目的 探讨联合检测血清人绒毛膜促性腺激素（β-HCG）、雌二醇（E2）、孕酮（P）、抗心磷脂抗体（ACA）预测先兆流产的结局.方法 选取孕6～8周单胎孕妇80例,其中先兆流产患者50例,正常妊娠者30例,检测血β-HCG、E2、P和ACA-IgG、ACA-IgM及ACA-IgA;先兆流产患者给予肌内注射黄体酮20 mg/次,1次/d,保胎治疗,1周后随访妊娠结局、复查血清学指标.结果 先兆流产组血β-HCG、E2和P水平[（5 140.77±2 365.47） IU/L、（680.28±306.06） pg/mL、（15.59±3.65） pg/L]均低于正常妊娠组[（14 520.4±11 016.24） IU/L、（1 142.81 ±670.57）pg/mL、（27.6 ±4.78） pg/L],差异均有统计学意义（分别t=3.224,P=0.003;t =2.43,P=0.022;=7.72,P=0.001）;1周后随访妊娠结局：继续妊娠45例,流产5例,复查血β-HCG、E2和P,继续妊娠组血β-HCG、E2和P水平[（10 829.42±6 926.28） IU/L、（832.9±397.91） pg/mL、（25.62 ±4.51） pg/L]明显较流产组高[（6 310.14±2 593.19） IU/L、（487.14±275.47） pg/mL、（13.6±4.84） pg/L],差异均有统计学意义（均P＜0.05）;检测80例孕妇血清ACA-IgG、ACA-IgM及ACA-IgA,2例先兆流产患者ACA-IgG阳性,其余均为阴性,阳性率4％ （2/50）,差异有统计学意义（x2=68.05,P=0.000）,随诊此2例患者早期自然流产.结论 联合检测血ACA、β-HCG、E2和P有助于先兆流产的预后判断.ACA与先兆流产的关系需进一步研究.Objective To explore the clinical value of combined detection of serum beta human chorionic gonadotropin （β-hCG）,estradiol （E2）,progesterone （P） and antiphospholipid antibodies （ACA） in predicting the outcomes of early threatened abortion.Methods 80 pregnant women were chosen from six to eight weeks singleton pregnancies,50 cases of threatened abortion and 30 cases of normal pregnancy.The serum levels of β-HCG,estradiol,progesterone and ACA-IgG,ACA-IgM and ACA-IgA were detected.The threatened abortion patients were given intramuscular progesterone 20 mg/day/time for 1 week,then,the pregnancy outcomes were analyzed and the serum levels of β-HCG,estradiol and progesterone were explored.Results The serum β-HCG,estradiol and progesterone of the threatened abortion group [（5 140.77 ± 2 365.47） IU/L,（680.28 ± 306.06） pg/mL,（15.59 ± 3.65） pg/L]were lower than those of the normal pregnant women [（14 520.4 ± 11 016.24） IU/L,（1 142.81 ± 670.57） pg/mL,（27.6 ± 4.78） pg/L] （t =3.224,P =0.003 ; t =2.43,P =0.022 ; t =7.72,P =0.001）.According to pregnancy outcome,patients with threatened miscarriages were divided into the two groups,including 45 patients with continuing pregnancies and 5 patients with inevitable miscarriages.The serum levels of β-HCG,estradiol and progesterone in ongoing pregnancies group [（10 829.42 ± 6 926.28） IU/L,（832.9 ± 397.91） pg/mL,（25.62 ± 4.51） pg/L] were higher than those in inevitable miscarriages [（6 310.14 ± 2 593.19） IU/L,（487.14 ± 275.47） pg/mL,（13.6 ±4.84） pg/L] （P 〈 0.05） ;The serum levels of ACA-IgG,ACA-IgM and ACA-IgA in 80 cases tested,only 2 cases who appeared in the threatened abortion group were detected with the positive of serum ACA-IgG,accounted for 4% （2/50） （x2 =68.05,P =0.000）,occurred spontaneous abortion in the end.Conclusion Combined detection of serum ACA,β-HCG,estradiol and progesterone may be helpful for prognosis of threatened abortion.However,the clinical predictive value of A

关 键 词：先兆流产 人绒毛膜促性腺激素 雌二醇 孕酮 抗心磷脂抗体 预后 

分 类 号：R714.21[医药卫生—妇产科学]