结合血清β-HCG、E2、P及E2/P对391例肾虚型早孕患者妊娠结局的回顾性研究  

Retrospective Study of Pregnancy Outcome of 391 Early Pregnant Women Based on Serum β-HCG,E2,P and E2/P Levels

作　　者：胡樱[1] 姚欣 叶华 HU Ying;YAO Xin;YE Hua(Jiangxi Provincial Hospital of Traditional Chinese Medicine,Nanchang 330004 Jiangxi,China;Huangshi Municipal Hospital of Traditional Chinese Medicine,Huangshi 435000 Hubei,China;Jiangxi University of Traditional Chinese Medicine,Nanchang 330004 Jiangxi,China)

机构地区：[1]江西省中医院,江西南昌330004 [2]黄石市中医院,湖北黄石435000 [3]江西中医药大学,江西南昌330004

出　　处：《广州中医药大学学报》2020年第2期243-249,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】了解血清人绒毛膜促性腺激素(HCG)、雌二醇(E2)、孕酮(P)及雌二醇/孕酮(E2/P)对诊断胚胎停育的能效性,观察正常妊娠与胚胎停育患者以上检测指标的数值上的差异,以发现影响胚胎停育的相关因素。【方法】选取391例先兆流产(中医胎漏、胎动不安)且辨证分型属肾虚型的早孕妇女为研究对象,根据妊娠结局分为妊娠组202例和胚停组189例。观察2组患者的一般情况(年龄、血型和停育时间)及既往孕产史(孕次、产次和胚胎停育次数),并于妊娠6~10周(W)观察血清HCG、E2、P以及E2/P的变化情况。【结果】(1)一般情况:胚停组患者的年龄高于妊娠组(P<0.01),但2组血型比较,差异无统计学意义(P>0.05);其中胚停组患者的平均停育天数为(65.77±9.20)d。(2)既往孕产史:胚停组患者的既往产次高于妊娠组(P<0.01),但2组患者的孕次和既往胚胎停育次数比较,差异均无统计学意义(P>0.05)。(3)妊娠组患者在妊娠6~10W的HCG、E2、P及E2/P值均明显高于胚停组(P<0.05)。(4)对于妊娠6~7 W胚胎的检测,E2优于HCG、E2/P,HCG、E2/P优于P(P<0.05),而HCG与E2/P的诊断效果相当(P>0.05)。对于妊娠8 W胚胎的检测,E2、HCG显著优于E2/P,E2/P显著优于P(P<0.05),而HCG与E2的诊断效果相当(P>0.05)。对于妊娠9~10 W胚胎停育的检测,E2显著优于E2/P、HCG,E2/P、HCG显著优于P(P<0.05),而E2/P与HCG诊断效果相当(P>0.05)。【结论】初步获得在妊娠6~10周诊断胚胎停育患者血清HCG、E2、P及E2/P的截断值,为预测早期妊娠结局提供了参考范围。对诊断胚胎停育的临床效能,E2最高,HCG次之,P最低,E2/P明显优于P,且除第8周外均与HCG诊断效能相当。Objective To investigate the efficiency of serum human chorionic gonadotropin(HCG),estradiol(E2),progesterone(P)and E2/P in the diagnosis of embryonic diapause,as well as the numerical differences between the above-mentioned indicators of normal pregnancy and embryonic diapause,so as to find out the factors affecting embryonic diapause.Methods A total of 391 early pregnant women with threatened abortion(known as vaginal bleeding during pregnancy or excessive fetal movement in the field of traditional Chinese medicine)differentiated as kidney deficiency syndrome were chosen as the study subjects.According to the pregnancy outcome,202 cases were allocated to pregnancy group and 189 cases were allocated to embryonic diapause group.The general data of age,blood type,and time for embryonic diapause,and the history of pregnancy and childbirth including the times for gravidity,parity and embryonic diapause in the two groups were collected.During the pregnant week 6-10,the changes of serum HCG,E2,P and E2/P were monitored.Results(1)The average age of the embryonic diapause group was older than that of the pregnancy group(P<0.01),but the difference of blood type between the two groups was not statistically significant(P>0.05).The average time for embryonic diapause in the embryonic diapause group was(65.77±9.20)days.(2)The times for parity in the embryonic diapause group was higher than that in the pregnancy group(P<0.01),but the differences of times for gravidity and embryonic diapause in the two groups were not statistically significant(P>0.05).(3)During the pregnant week 6-10,the serum levels of HCG,E2,P and E2/P in the pregnancy group were higher than those in the embryonic diapause group(P<0.05).(4)For the detection of the embryo during the pregnant week 6-7,the efficiency of E2 was superior to that of HCG and E2/P,the efficiency of HCG and E2/P was superior to that of P(P<0.05),but the efficiency of HCG was similar to that of E2/P(P>0.05).For the detection of the embryo at the pregnant week 8,the efficiency of E2 a

关 键 词：先兆流产 胎漏 胎动不安 肾虚型 胚胎停育 人绒毛膜促性腺激素 雌二醇 孕酮 雌二醇/孕酮 

分 类 号：R271.9[医药卫生—中西医结合] R714.21[医药卫生—中医妇科学]