SD/CRL比值联合血β-HCG、E2水平对IVF/ICSI-ET早期流产的预测价值  

Predictive value of SD/CRL ratio combined with serumβ-HCG and E2 levels in early abortion of patients undergoing IVF/ICSI-ET

作　　者：芦爱华 赵永新 李洁 刘瑞 LU Aihua;ZHAO Yongxin;LI Jie;LIU Rui(Department of Women Health Care,Qinghai Maternal and Child Health Hospital,Xining,Qinghai,China,810007;Department of Gynecology,Qinghai Red Cross Hospital,Xining,Qinghai,China,810007)

机构地区：[1]青海省妇幼保健院妇女保健科,青海西宁810007 [2]青海省红十字医院妇三科,青海西宁810007

出　　处：《分子诊断与治疗杂志》2020年第10期1371-1374,1379,共5页Journal of Molecular Diagnostics and Therapy

基　　金：青海省(应用)基础研究计划项目(2019-ZJ-189)。

摘　　要：目的观察孕囊直径/胚胎头臀长(SD/CRL)比值联合血β-人绒毛膜促性腺激素(β-HCG)、雌二醇(E2)水平对体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)早期流产的预测价值。方法对本院328个IVF/ICSI-ET周期患者进行分析,比较早期流产组与非早期流产组血清β-HCG水平、E2水平、SD/CRL比值及不同临床资料,进行早期流产影响因素分析,探讨SD/CRL联合血β-HCG、E2水平对早期流产的预测价值。结果早期流产组血清β-HCG、E2水平显著低于非早期流产组,差异具有统计学意义(P<0.05),SD/CRL比值显著高于非早期流产组,差异具有统计学意义(P<0.05);>35岁者早期流产率显著高于30~35岁者与<30岁者,且30~35岁者显著高于<30岁者,差异具有统计学意义(P<0.05);年龄、SD/CRL比值属于患者早期流产独立危险因素(P<0.05),移植后14 d血清β-HCG、E2为早期流产保护因素(P<0.05);E2预测早期流产敏感度81.7%,特异度71.5%;β-HCG敏感度82.8%,特异度79.3%;SD/CRL敏感度86.9%,特异度73.1%;三者联合敏感度91.7%,特异度89.2%。结论SD/CRL比值联合血β-HCG、E2可为IVF/ICSI-ET早期流产预测提供重要依据,对临床工作开展具有指导意义。Objective To observe the predictive value of gestational sac diameter/crown-rump length(SD/CRL)ratio combined with serumβ-human chorionic gonadotropin(β-HCG)and estradiol(E2)levels in early abortion of patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET).Methods A retrospective analysis was performed among 328 patients receiving IVF/ICSI-ET in the hospital.The levels of serumβ-HCG and E2,SD/CRL ratio and clinical data were compared between the early abortion group and the non-early abortion group.Influencing factors of early abortion were analyzed.The predictive value of SD/CRL ratio combined with serumβ-HCG and E2 levels for early abortion was discussed.Results Theserumβ-HCG and E2 levels of the early abortion group were significantly lower than those of the non-early abortion group(P<0.05),while SD/CRL ratio was significantly higher than that of the non-early abortion group(P<0.05).The early abortion rate in>35 years old group was significantly higher than that in 30~35 years old and<30 years old groups,and the 30~35 years old group was significantly higher than those under 30 years old group(P<0.05).Age and SD/CRL ratio were independent risk factors for early abortion(P<0.05),while serumβ-HCG and E2 at 14 d after transplantation are protective factors(P<0.05).The sensitivity and specificity of E2,β-HCG,SD/CRL ratio and their combination for predicting early abortion were(81.7%,71.5%),(82.8%,79.3%),(86.9%,73.1%)and(91.7%,89.2%),respectively.Conclusion The SD/CRL ratio combined with serumβ-HCG and E2 can provide an important basis for the prediction of early abortion of patients undergoing IVF/ICSI-ET,which is of great significance for clinical practice.

关 键 词：孕囊直径/胚胎头臀长 Β-人绒毛膜促性腺激素 雌二醇 体外受精/卵胞质内单精子注射-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学] R714.21[医药卫生—临床医学]