先兆流产患者孕早期血清孕酮、雌二醇和尿I-HCG/HCGRP变化及其妊娠结局影响因素分析  

Changes of Serum Progesterone, Estradiol, Urine I-HCG/HCGRP in the First Trimester of Patients with Threatened Abortion and Factors Affecting Pregnancy Outcomes

作　　者：薛楠 黄鲁 郑桂香[1] 李婷[1] XUE Nan;HUANG Lu;ZHENG Gui-xiang;LI Ting(Department of Obstetrics and Gynecology,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院妇产科,北京100730

出　　处：《临床误诊误治》2021年第9期83-88,共6页Clinical Misdiagnosis & Mistherapy

基　　金：北京市科委科技计划项目(Z181100001818035)。

摘　　要：目的探讨先兆流产患者孕早期血清孕酮、雌二醇和尿完整型人绒毛膜促性腺激素(I-HCG)/人绒毛膜促性腺激素相关蛋白(HCGRP)变化及其妊娠结局影响因素。方法选取2018年1月—2020年5月收治的先兆流产98例,按照孕12周超声检查妊娠结局将其分为正常妊娠组(60例)和难免流产组(38例)两组。观察比较两组保胎前和保胎6、9周时血清孕酮、雌二醇水平和尿I-HCG/HCGRP,采用单因素和多因素Logistic回归分析探讨先兆流产患者妊娠结局影响因素。结果保胎6和9周时,血清孕酮和雌二醇水平两组均较保胎前升高,且正常妊娠组高于难免流产组;保胎9周时,血清孕酮和雌二醇水平两组均较保胎6周时升高,差异有统计学意义(P<0.05或P<0.01)。保胎6和9周时,尿I-HCG/HCGRP阳性2所占比例两组均较保胎前降低,正常妊娠组低于难免流产组;保胎9周时,尿I-HCG/HCGRP阳性2所占比例两组均较保胎6周时降低,差异有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,宫内大血肿、黄体功能不全及血清孕酮异常、血清雌二醇异常、尿I-HCG/HCGRP阳性2表达为影响先兆流产患者妊娠结局的独立危险因素(P<0.05或P<0.01)。结论孕早期血清孕酮、雌二醇异常和尿I-HCG/HCGRP阳性2表达是影响先兆流产患者妊娠结局的独立危险因素。临床可通过监测孕早期血清孕酮、雌二醇和尿I-HCG/HCGRP动态变化预测先兆流产患者妊娠结局,以判断是否继续妊娠。Objective To investigate changes of serum progesterone,estradiol and urine intact human chorionie gonadotropin(I-HCG)/human chorionic gonadotropin related protein(HCGRP)in the first trimester of patients with threatened abortion and factors affecting pregnancy outcomes.Methods A total of 98 patients with threatened abortion admitted between January 2018 and May 2020 were selected,and the patients were divided into normal pregnancy group(n=60)and inevitable abortion group(n=38)according to the pregnancy outcome after pregnancy for 12 weeks by ultrasound examinations.Changes of progesterone,estradiol and urinary I-HCG/HCGRP before and after tocolyis treatment for 6 weeks and 9 weeks were observed and compared between two groups.Univariate and multivariate logistic regression analyses were used to analyze independent risk factors affecting the pregnancy outcomes of patients with threatened abortion.Results After tocolyis treatment for 6 weeks and 9 weeks,serum levels of progesterone and estradiol were significantly higher than those before tocolyis treatment in two groups,and the levels in normal pregnancy group were significantly higher than those in inevitable abortion group;after tocolyis treatment for 9 weeks,levels of progesterone and estradiol in both groups were significantly higher than those after tocolyis treatment for 6 weeks in two groups(P<0.05 or P<0.01).After tocolyis treatment for 6 weeks and 9 weeks,proportions of urinary I-HCG/HCGRP positive 2 were significantly lower than those before tocolyis treatment in two groups,and the proportions in normal pregnancy group were significantly lower than those in inevitable abortion group;after tocolyis treatment for 9 weeks,proportions of urinary I-HCG/HCGRP positive 2 were significantly lower than those after tocolyis treatment for 6 weeks in two groups(P<0.05 or P<0.01).Multivariate logistic regression analysis showed that intrauterine large hematoma,luteal insufficiency,abnormal progesterone,abnormal estradiol and urinary I-HCG/HCGRP positive 2 expression

关 键 词：流产 先兆 雌二醇 孕酮 完整型人绒毛膜促性腺激素/人绒毛膜促性腺激素相关蛋白 妊娠结局 影响因素分析 

分 类 号：R714.2[医药卫生—妇产科学]