血清β-绒毛膜促性腺激素在预测持续性异位妊娠中的价值  

Value of serum β-human chorionic gonadotropin as a predictor of persistent ectopic pregnancy

作　　者：张健[1] 谢康云[1] 花琪[1] 

机构地区：[1]中国福利会国际和平妇幼保健院,上海200030

出　　处：《上海医学》2003年第10期714-716,共3页Shanghai Medical Journal

摘　　要：目的　探讨血清 β 绒毛膜促性腺激素 (hCG)水平在预测输卵管妊娠保守性手术后发生持续性异位妊娠(PEP)中的价值。方法　我院 6年来因输卵管妊娠行保守性手术 2 16例 ,术后发生PEP 2 1例 (PEP组 )、未发生PEP 195例(非PEP组 ) ,比较两组患者术前及术后血清 β hCG水平及其变化。 结果　PEP组术前 2d内血清 β hCG水平明显高于非PEP组 (P <0 .0 5 ) ;术后第 4天PEP组的血清 β hCG隔日下降率明显低于非PEP组 (P <0 .0 0 1)。若以患者术前 2d内血清 β hCG≥30 0 0mU/ml结合术后第 4天的血清 β hCG隔日下降率≤ 2 0 %为阈值 ,则预测发生PEP的敏感性和特异性分别为 0 .79和 0 .93。结论　术前 2d内血清 β hCG水平结合术后第 4天血清βObjective To assess the value and changes of serum β- human chorionic gonadotropin (β-hCG) levels to predict the presence of persistent ectopic pregnancy (PEP) after conservative operation on tubal pregnancy. Methods The data of 216 patients with tubal pregnancy treated by conservative operation during the past six years in our hospital were reviewed. 21 were diagnosed as having PEP(PEP group),and 195 patients as having no PEP (NPEP group). The serum β-hCG levels were compared preoperatively and postoperatively in the two groups retrospectively. Results The preoperative serum β-hCG level was significantly higher 2 days before the operation in PEP group compared with that of the NPEP group(P <0.05). The fall of serum β-hCG on alternate days after the operation was significantly lower in PEP group compared with that of the NPEP group(P <0.001). Taking preoperative serum β-hCG level within 2 days before the operation ≥ 3 000 mU/ml and ≤20% decline at day 4 postoperatively on alternate days as the cut-off value, the sensitivity and specificity of the test were 0.79 and 0.93, respectively. Conclusion Preoperative serumβ-hCG level 2 days before the operation combining with decline on day 4 postoperatively at alternate days can predict the presence of PEP effectively.

关 键 词：血清 Β-绒毛膜促性腺激素 预测 持续性异位妊娠 输卵管妊娠 保守性手术 术后并发症 

分 类 号：R714.22[医药卫生—妇产科学]