人绒毛膜促性腺激素、血管内皮生长因子、抑制素A水平与甲氨蝶呤对输卵管妊娠患者治疗效果的关系及其对保守治疗成功的预测效能  

The relationship between the dynamic changes of β-hCG, VEGF, INH-A and the efficacy of methotrexate in patients with tubal pregnancy and the efficacy of predicting the success of conservative treatment

作　　者：李丽君 王晓丽 LI Lijun;WANG Xiaoli(Department of Obstetrics and Gynaecology,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang 236000,Anhui,China)

机构地区：[1]安徽医科大学附属阜阳医院妇产科,安徽阜阳236000

出　　处：《中国性科学》2022年第8期37-41,共5页Chinese Journal of Human Sexuality

基　　金：安徽省卫生厅医药科研计划项目(12925KJ2017B71)。

摘　　要：目的探讨人绒毛膜促性腺激素(β-hCG)、血管内皮生长因子(VEGF)、抑制素A(INH-A)水平的动态变化与输卵管妊娠患者应用甲氨蝶呤治疗效果的关系及其预测保守治疗成功的效能。方法选取2017年7月至2020年12月安徽医科大学附属阜阳医院收治的147例采用甲氨蝶呤治疗的输卵管妊娠患者作为研究对象,根据治疗是否成功分为未成功组(n=21)、成功组(n=126)。比较两组治疗前及治疗后4d、7dβ-hCG、VEGF、INH-A水平;采用Pearson法分析VEGF、INH-A与β-hCG的相关性;采用多因素Logistic回归分析保守治疗成功的相关影响因素;采用受试者工作特征(ROC)曲线计算曲线下面积(AUC)评估各指标对保守治疗成功的预测价值,并采用二元拟合回归分析构建各指标联合的预测模型。结果成功组治疗后4d、7dβ-hCG、VEGF、INH-A水平低于未成功组(P<0.05);两组治疗后4d、7d VEGF、INH-A与β-hCG呈正相关(P<0.05);治疗后4d、7dβ-hCG、VEGF、INH-A是治疗成功的相关影响因素(P<0.05);ROC曲线显示,治疗后7dβ-hCG、VEGF、INH-A预测保守治疗成功的AUC大于治疗后4d,各指标联合预测保守治疗成功的AUC大于相同时间点任一单一指标。结论β-hCG、VEGF、INH-A与输卵管妊娠患者应用甲氨蝶呤治疗效果有关,三者联合检测对保守治疗结局具有良好的预测效能。Objective To investigate the relationship between the dynamic changes ofβ-human chorionic gonadotropin(β-hCG),vascular endothelial growth factor(VEGF),inhibin-A(INH-A)and the efficacy of methotrexate in patients with tubal pregnancy and the efficacy of predicting the success of conservative treatment.Methods 147 patients with tubal pregnancy treated with methotrexate from July 2017 to December 2020 admitted to Fuyang Hospital Affiliated of Anhui Medical University were selected as study subjects,and divided into unsuccessful group(n=21)and successful group(n=126)according to whether the treatment was successful or not.The levels ofβ-hCG,VEGF,and INH-A before and 4d and 7d after treatment were compared between the two groups;Pearson analysis was used to analyze the correlation between VEGF,INH-A andβ-hCG,and multi-factor Logistic regression was used to analyze the influencing factors related to the success of conservative treatment;the area under the curve(AUC)was calculated using the receiver operating characteristic(ROC)curve to assess the predictive value,and binary fitted regression analysis was used to construct a prediction model for the combination of each index.Resultsβ-hCG,VEGF and INH-A in the successful group were lower than those in the unsuccessful group at 4d and 7d after treatment(P<0.05);VEGF,INH-A were positively correlated withβ-hCG at 4d and 7d after treatment in both group(P<0.05);β-hCG,VEGF,INH-A are the related influencing factors of treatment success at 4d and 7d after treatment(P<0.05);ROC curve shows AUC ofβ-hCG,VEGF,and INH-A in predicting the success of conservative treatment at 7d after treatment was greater than that at 4d after treatment,and the AUC of each index combined in predicting the success of conservative treatment was greater than that of any single index at the same time point.Conclusionsβ-hCG,VEGF,INH-A are related to the efficacy of methotrexate in patients with tubal pregnancy,and the combined detection of the three has a good predictive effect on the outcome of

关 键 词：人绒毛膜促性腺激素 血管内皮生长因子 抑制素A 输卵管妊娠 甲氨蝶呤 保守治疗 

分 类 号：R711[医药卫生—妇产科学]