摘要
目的探讨血清β人绒毛膜促性腺激素(β-hCG)、子宫内膜厚度检测与不明位置妊娠(PUL)患者妊娠结局的关系。方法选取重庆开县人民医院产科确诊的129例PUL患者进行回顾性分析,其中妊娠结局为宫内孕的有49例(宫内孕组)、宫外孕38例(宫外孕组)、自然流产42例(自然流产组),检测并比较3组研究对象的β-hCG、子宫内膜及相关激素水平并进行组间比较,同时采用受试者工作曲线(ROC)判断β-hCG、子宫内膜厚度诊断异位妊娠的价值。结果宫外孕组、宫内孕组、自然流产组的入院时β-hCG水平、48h后的β-hCG水平、β-hCG比值、子宫内膜厚度值差异均具有统计学意义(F值分别为19.082、28.336、11.205、7.021,均P<0.05);宫外孕组的入院时β-hCG水平、48h后的β-hCG水平、β-hCG比值均显著的小于宫内孕组、自然流产组,且差异均具有统计学意义(t值分别为11.296、23.825、7.652、6.398、7.025、4.336,均P<0.05),宫外孕组、自然流产组的子宫内膜厚度值均显著小于宫内孕组(t值分别为8.392、6.896,均P<0.05)。宫外孕组、宫内孕组、自然流产组的血清P、E_2水平差异均具有统计学意义(F值分别为14.582、22.039,均P<0.05);宫外孕组的入院时血清P、E_2水平均显著的小于宫内孕组、自然流产组,差异均具有统计学意义(t值分别为17.285、19.364、9.628、4.096,均P<0.05),自然流产组的血清P、E_2水平均显著的小于宫内孕组(t值分别为9.684、7.295,均P<0.05)。β-hCG比值对鉴别诊断宫外孕妊娠的灵敏度:88.41%、特异度:93.26%、β-hCG比值临界值为1.52,Auc=0.88;子宫内膜厚度值鉴别诊断宫外孕妊娠的灵敏度:61.39%、特异度:70.28%、子宫内膜厚度临界值为10.17mm,Auc=0.70;β-hCG比值联合子宫内膜厚度鉴别诊断宫外孕妊娠的灵敏度:92.04%、特异度:96.95%,Auc=0.93。结论早期检测β-hCG比值及子宫内膜厚度对于判断PUL孕妇妊娠情况、鉴别诊断宫外孕具有一定的价
Objective To investigate the correlation among serum β-human chorionic gonadotropin （β-hCG）, endometrial thickness and pregnancy outcomes of patients with pregnancies of unknown location （PUL）. Methods Retrospective study was conducted on 129 cases of PUL diagnosed in obstetrics department of Kaixian County People＇ s Hospital of Chongqing City, including 49 cases of intrauterine pregnancy （intrauterine pregnancy group）, 38 cases of ectopic pregnancy （ectopic pregnancy group） and 42 cases of spontaneous abortion （spontaneous abortion group）. Serum β-hCG, endometrium and related hormones levels of three groups were detected and compared. Receiver operating characteristics （ROC） curve was used to determine the value of 13-hCG and endometrial thickness in diagnosis of ectopic pregnancy. Results There were significant differences in 13-hCG level on admission, β-hCG level after 48h, β-hCG ratio and endometrial thickness among three groups （F value was 19. 082, 28. 336, 11. 205 and 7. 021, respectively, all P 〈 0.05）. Compared with intrauterine pregnancy group and spontaneous abortion group,β-hCG level on admission, β-hCG level after 48h andβ-hCG ratio were significantly lower in ectopic pregnancy group （ t value was 11. 296, 23. 825, 7. 652, 6. 398, 7. 025 and 4. 336, respectively, all P 〈 0.05 ）. Endometrial thickness of intrauterine pregnancy group was remarkably higher than that of ectopic pregnancy group and spontaneous abortion goup （t value was 8. 392 and 6. 896, respectively, both P 〈 0.05 ）. Among three groups serum P and E2 levels were different with statistical significance （ F value was 14. 582 and 22. 039, respectively, both P 〈 0.05 ） , and those levels were significantly lower in ectopic pregnancy group than in intrauterine pregnancy group and spontaneous abortion group （ t value was 17. 285, 19. 364, 9. 628 and 4. 096, respectively, all P 〈 0.05 ）. Serum P and E2 levels in spontaneous abortion group were significantly lower than those in int
出处
《中国妇幼健康研究》
2015年第6期1251-1253,1258,共4页
Chinese Journal of Woman and Child Health Research
关键词
Β人绒毛膜促性腺激素
子宫内膜厚度
不明位置妊娠
妊娠结局
Beta human chorionic gonadotropin ＂（β-hCG）
endometrial thickness
pregnancy of unknown location （PUL）
pregnancyoutcomes
