孕酮β-hCG联合CA125在先兆流产中的检测意义  

Significance of Progesterone beta-hCG combined with CA125 in Threatened Abortion

作　　者：张艳[1] 陈灵芝 ZHANG Yan(The First People＇s Hospital of Guangyuan,Sichuan Guangyuan 628017,China)

机构地区：[1]四川省广元市第一人民医院妇产科,四川广元628017 [2]河北省廊坊市第四人民医院妇科,河北廊坊065700

出　　处：《河北医学》2018年第11期1769-1773,共5页Hebei Medicine

基　　金：2013年四川省卫生厅科研课题项目;(编号:130529)

摘　　要：目的:分析先兆流产患者孕酮、绒毛膜促性腺素(β-hCG)、糖链蛋白125(CA125)检测的意义。方法:选择我院2015年5月至2016年11月收治的113例先兆流产患者,按妊娠结局不同分为65例先兆流产继续妊娠组及48例难免流产组。同期选择53例正常妊娠者。均以放射免疫法测定P、β-hCG、CA125水平,并观察比较各组血清P、β-hCG及CA125水平,明确先兆流产发生的可能危险因素,选用多元Logistic回归及受试者工作绘制特征(ROC)曲线分析孕酮、β-hCG及CA125与先兆流产的联系。结果:难免流产组孕酮、β-hCG水平低于先兆流产继续妊娠组且低于正常妊娠组(11.70±1.26)、(24.09±3.19)、(26. 70±4. 20) mg/m L,(1879. 53±220. 18)、(6982. 11±876. 10)、(7035. 96±965. 12)m U/m L,CA125高于先兆流产继续妊娠组且高于正常妊娠组(57.88±8.96)、(27.63±3.41)、(19.40±2.76) U/m L,差异有统计学意义(P <0.05)。Logistic回归分析,孕酮、β-hCG及CA125水平为先兆流产发生的独立影响因素。ROC曲线下显示,P曲线下面积为0.723(95%cCI为0.628~0.819),敏感度及特异度分别为0.406和0.761;β-hCG曲线下面积为0.513(95%CI为0.406~0.620),敏感度及特异度分别为0.653和0.672; CA125曲线下面积为0.812(95%CI0.737~0.888),敏感度和特异度分别为0.782和0.567,联合检测曲线下面积为0.857(95%CI为0.790~0.924),敏感度及特异度分别为0.663和0.716,联合检测曲线下面积明显高于单个指标。结论:孕酮、β-hCG及CA125能够客观反映妊娠状态,预测先兆流产,提高临床诊断,从而利于临床治疗。Objective： To analyze the clinical value of progesterone, chorionic gonadin （β-hCG） andglycoprotein 125 （CA125） detection in patients with threatened abortion. Methods： 113 cases of threatenedabortion admitted in our hospital from May 2015 to November 2016 were divided into 65 cases of threatened abortion continuing pregnancy group and 48 cases of inevitable abortion group according to pregnancy outcome.53 normal pregnancies were selected at the same time. The levels of progesterone, beta-hCG and CA125 weremeasured by radioimmunoassay. The serum levels of progesterone, beta-hCG and CA125 in each group wereobserved and compared. The possible risk factors of threatened abortion were identified. The relationship between P, beta-hCG and CA125 and threatened abortion was analyzed by multiple logistic regression and ROCcurve. Results： The levels of progesterone and beta -hCG in the inevitable abortion group were lower thanthose in the threatened abortion group and were lower than those in the normal pregnancy group （11.70 [1.26], （24.09 [3.19], （26.70 [4.20] mg / mL, （1879.53 [220.18], （6982.11 [876.10], （7035.96[965.12] mU / ml. CA125 was higher in threatened abortion group than in continuing pregnancy group andhigher than in normal pregnancy group （57.88 [8.96], （27.63 [3.41], （19.40 [2.76] U/ mL. The difference was statistically significant （P〈0.05）. Logistic regression analysis showed that serum progesterone, beta-hCG and CA125 levels were independent factors influencing the occurrence of threatened abortion. ROCcurve showed, area under progesterone curve was 0.723 （95%CI was 0.628-0.819）, and the sensitivity andspecificity were 0.406 and 0.761. The area under the β-hGG curve was 0.513 （95%CI was 0.406-0.620）,and the sensitivity and specificity was 0.653 and 0.672. Area under curve of CA125 was 0.812 （95% CI 0.737-0.888）, the sensitivity and specific degree was 0.782 and 0.567, the joint detection area under the curvewas 0.857 （95% CI was 0.790-0.924）, sensiti

关 键 词：先兆流产 孕酮 绒毛膜促性腺素 糖链蛋白125 

分 类 号：R714.21[医药卫生—妇产科学]