冻胚移植后第12天血液β-HCG水平对妊娠结局的预测价值  

The predictive value of blood β-HCG level 12 days after frozenembryo transplantation for pregnancy outcome

作　　者：满姗姗 高选 MAN Shan-shan;GAO Xuan(State Key Laboratory of Reproductive Medicine and Offspring Health,Center for Reproductive Medicine,Institute of Women,Children and Reproductive Health,Shandong Jinan 250012)

机构地区：[1]山东大学妇儿与生殖健康研究院/山东大学附属生殖医院/山东大学生殖医学与子代健康全国重点实验室/山东大学国家辅助生殖与优生工程技术研究中心/山东大学生殖内分泌教育部重点实验室/山东省生殖健康技术创新中心/山东省生殖健康临床医学研究中心/山东省生殖生育研究与出生缺陷防控重点实验室/中国医学科学院配子发生与辅助生殖子代健康研究创新单元(2021RU001),山东济南250012

出　　处：《医学检验与临床》2025年第3期24-28,共5页Medical Laboratory Science and Clinics

基　　金：中国医学科学院配子发生与辅助生殖子代健康研究创新单元,项目编号:2021RU001。

摘　　要：目的:根据冻胚移植的妊娠结局,探讨分析其移植后第12天(12d)血液β-HCG的诊断截断点。方法:回顾性分析于2022年1月-2023年6月在本中心接受辅助生殖治疗冻胚移植的患者临床资料,共2040例。根据妊娠结局分为不良妊娠组(生化妊娠、异位妊娠、早期流产)、继续妊娠组(单胎、双胎),分析移植后12d区分各妊娠结局的血β-HCG的诊断截断点。结果:各妊娠结局组间年龄、BMI指标差异没有统计学意义。冻胚移植后12d血液β-HCG浓度不良妊娠组(生化妊娠<异位妊娠<早期流产)<继续妊娠组(单胎<双胎),用于区分不同结局的β-HCG浓度差异有统计学意义。72.87mIU/mL、250.9mIU/mL、520.7mIU/mL、927.9mIU/mL可分别作为区分生化妊娠、异位妊娠、早期流产、单胎、双胎的诊断截断点,所对应的灵敏度/特异度分别为92.3%/75.8%、92.3%/75.5%、73.0%/57.4%、58.7/70.9,曲线下面积(AUC)分别为0.858、0.824、0.682、0.668。生化妊娠与早期流产的诊断截断点/灵敏度/特异度/AUC分别为:125.3mIU/mL/91.7%/85.2%/0.939。不良妊娠组和继续妊娠组中移植冻胚数量没有显著差异。结论:冻胚移植后12d血液β-HCG水平对妊娠结局具有良好的预测价值。Objective:According to the pregnancy outcome,to analyze the diagnostic threshold of bloodβ-HCG level 12 days(12 d)after frozen embryo transplantation.Methods:Retrospectively analyze clinical data from 2040 individuals who received frozen embryo transplantation in our center from January 2022 to June 2023.According to the pregnancy outcome,they were divided into adverse pregnancy group(biochemical pregnancy,ectopic pregnancy,early abortion)and continued pregnancy group(single pregnancy,twin pregnancy),then the diagnosticβ-HCG threshold dividing each outcome was analyzed.Results:There was no significant dfference in age and BMI among different pregnancy outcome groups.The difference of bloodβ-HCG concentration at 12 d after frozen embryo transplantation was significantly different between adverse pregnancy group(biochemical pregnancy<ectopic pregnancy<early abortion)and continued pregnancy group(single pregnancy<twin pregnancy):72.87 mIU/mL,250.9 mIU/mL,520.7 mIU/mL and 927.9 mIU/mL can be used as the diagnostic cutof points to distinguish biochemical pregnancy,ectopic pregnancy,early abortion,single pregnancy,and twin pregnancy,respectively.The sensitivity and specificity were 92.3%/75.8%,92.3%/75.5%,73.0%/57.4%,58.7/70.9,and AUC were 0.858,0.824,0.682,0.668,respectively.Diagnostic cut-off point/sensitivity/specificity/AUC for biochemical pregnancy versus early abortion were 125.3 mIU/mL/91.7%/85.2%/0.939.There was no significant difference between the number of frozen embryos transplanted among different pregnancy groups.Conclusion:Bloodβ-HCG level at 12 days after frozen embryo transplantation has high predictive value for pregnancy outcome.

关 键 词：冻胚移植 HCG 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]