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目的通过分组对比,探讨动态监测血清孕酮及人绒毛膜促性腺激素-β亚单位(β-hCG)对早期异常宫内妊娠预后判定的价值。方法以该院妇产科门诊2012年5月~2014年10月诊治的有阴道出血的182例早期异常宫内妊娠患者为研究对象,将患者按照其妊娠结局分为3组:65例先兆流产继续妊娠患者设为先兆续妊组,56例稽留流产患者设为稽留组,61例难免流产患者设为难免组。自就诊之日起动态监测血清孕酮及β-β-hCG,计算孕酮及β-β-hCG的变化率,并随访其妊娠结局。结果难免组第2次检测的β-β-hCG及孕酮均低于第1次检测结果(P<0.001);其他两组第2次检测的β-β-hCG均高于第1次检测结果(P=0.007,P<0.001),而孕酮的两次检测结果比较差异无统计学意义(P=0.935,P=0.05)。β-β-hCG的变化率以先兆续妊组为最大(与其他两组比较,均为P<0.01),稽留组最小(与其他两组比较,均为P<0.01)。孕酮的变化率以难免组为最大(与其他两组比较,均为P<0.01),而其他两组孕酮的变化率比较差异无统计学意义(P=0.211)。结论对血清孕酮及β-β-hCG执行动态监测可以快速简单地诊断难免流产,而动态监测血清孕酮及β-β-hCG的变化趋势及变化幅度,可以为鉴别稽留流产及先兆流产继续妊娠提供依据。
Objective To compare the value of serum progesterone and β-hCG in predicting the prognosis of early abnormal intrauterine pregnancy by grouping and comparing the serum progesterone and human chorionic gonadotropin-β subunit (β-hCG). Methods A total of 182 cases of early abnormal intrauterine pregnancy with vaginal bleeding diagnosed and treated in the hospital obstetrics and gynecology clinic from May 2012 to October 2014 were divided into three groups according to their pregnancy outcome: 65 cases of threatened abortion 56 cases of missed abortion were set as the remission group and 61 cases of unavoidable miscarriage were set as the inevitable group. Serum progesterone and β-β-hCG were monitored dynamically from the date of treatment, and the rate of change of progesterone and β-β-hCG was calculated. The pregnancy outcome was followed up. Β-β-hCG and progesterone in the second test were lower than those in the first test (P <0.001). Β-β-hCG in the second test was higher than that of the first test Results (P = 0.007, P <0.001). There was no significant difference between the two test results of progesterone (P = 0.935, P = 0.05). The rate of change of β-β-hCG was the highest in preeclampsia (P <0.01 compared with the other two groups), and the smallest in remaining group (P <0.01 compared with the other two groups). The rate of change of progesterone was the largest in the unavoidable group (all P <0.01 compared with the other two groups), while the progesterone in the other two groups showed no significant difference (P = 0.211). Conclusions The dynamic monitoring of serum progesterone and β-β-hCG can quickly and easily diagnose unavoidable abortion. However, the dynamic changes of serum progesterone and β-β-hCG and the changes of β-β-hCG can be used to identify missed abortion and threatened abortion Pregnancy provide the basis.