取卵后第17天血清β-hCG预测体外受精-胚胎移植早期妊娠结局的价值  

Predictive value of serum β-hCG levels at 17 days after ovulation on early pregnaney outcome in vitro fertilization-embryo tranfer

作　　者：任建枝[1] 郑仁瑞[1] 沙爱国[1] 李萍[1] 邱慧玲[1] 周友泉[1] 黄扉[1] 

机构地区：[1]解放军第174医院,福建厦门361002

出　　处：《山东医药》2003年第24期10-12,共3页Shandong Medical Journal

摘　　要：目的　探讨取卵后第 17天血清人绒毛膜促性腺激素 (h CG)水平预测体外受精 -胚胎移植早期妊娠结局的价值。方法　对取卵后第 17天血清 β- h CG(d1 7β- h CG) >10 IU/L 的 74例患者的 d1 7β- h CG水平与取卵后 38天超声诊断的早期妊娠结局进行对比分析。结果　 d1 7β- h CG13.0～ 15 6 8.2 IU/L,平均 (5 5 6 .7± 44 0 .5 ) IU/L。其中生化妊娠 13例、宫外妊娠 5例、单胎妊娠 31例、多胎妊娠 2 5例 ,继续妊娠 5 3例、早期流产 3例。生化妊娠、宫外妊娠、单胎妊娠、多胎妊娠组血清 d1 7β- h CG分别为 (48.2± 5 0 .9) IU/L、(182 .0± 6 3.8) IU/L、(5 0 6 .8± 2 81.9) IU/L、 (995 .0± 34 1.5 ) IU/L ,它们之间的差异均有显著性 (P <0 .0 5或 P <0 .0 0 1)。继续妊娠组血清 d1 7β- h CG(6 86 .7± 36 6 .5 ) IU /L较流产组 (2 39.6± 397.7) IU /L明显高 (P <0 .0 0 1)。血清 d1 7β- h CG<10 0 IU /L预测生化妊娠的灵敏度为 84.6 %、特异度为 98.4%;d1 7β- h CG10 0～ 2 99IU/L 预测宫外妊娠的灵敏度为 10 0 .0 %、特异度为92 .5 %;d1 7β- h CG30 0～ 799IU/L 预测单胎妊娠的灵敏度为 6 4.5 %、特异度为 83.7%;d1 7β- h CG≥ 80 0 IU/L 预测多胎妊娠的灵敏度为 72 .0 %、特异度为 89.8%;d1Objective To determine the predictive value of serum human chorionic gonadotropin(hCG) levels at 17 days after ovalution on early pregnancy outcome following embryo transfer.Methods Serum β-hCG at 17 days(d 17β-hCG) after ovulation was>10 IU/L in 74 cases who were detected by ultrasound at 38 days after ovulation to comform pregnancy outcome.Results Serum d 17 β-hCG was 13.0 to 1568.2 IU/L?The overall outcome were 13 biochemcal pregnancies,5 ectopic pregnancies,31 singletons and 25 multiple pregnancies.There were 53 on going pregnancies and 3 frist trimester abortions.Serum d 17β-hCG of biochemcal pregnancy were (48.2±50.9)IU/L,ectopic pregnancy were(182.0±63.8)IU/L,singleton were (506.8±281.9)IU/L and multiple pregnancy were (995.0±341.5)IU/L. There were signifficant difference(P<0.05 or P<0.001). Serum d 17 β-hCG (686.7±366.5)IU/L of on going pregnancy were signifficantly higher than that of abortion (239.6±397.7)IU/L (P<0.001). Serum d 17 β-hCG <100 IU/L,the sensitivity was 84.6% and the specificity was 98.4% to detect biochemcal pregnancy.Serum d 17 β-hCG 100~299 IU/L,the sensitivity was 100.0% and the specificity was 92.5% to detect ectopic pregnancy.Serum d 17 β-hCG 300~799 IU/L,the sensitivity was 64.5% and the specificity was 83.7% to detect singleton.Serum d 17 β-hCG≥800 IU/L,the sensitivity was 72.0% and the specificity was 89.8% to detect multiple pregnancy.Serum d 17 β-hCG ≥300 IU/L,the sensitivity was 94.0% and the specificity was 75.0% to detect on going pregnancy.Conclusion Serum β-hCG levels of 17 days after ovulation is a useful predictor of early pregnancy outcome.

关 键 词：体外受精 胚胎移植 Β-HCG 预测 诊断 早期妊娠结局 对比分析 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学] R711.6[医药卫生—基础医学]