先兆流产患者血清HCG,孕酮,CA125水平的检测

目的探讨血清癌抗原125（CAl25）、人绒毛膜促性腺激素（HCG）和孕酮联合监测对先兆流产的预测价值。方法选择115例孕龄5～8周的单胎孕妇,根据妊娠结局将其分为3组：正常妊娠组30例,先兆流产组55例,难免流产组30例。测定3组血清CAl25、孕酮及HCG水平。结果与结论先兆流产继续妊娠组和难免流产组孕妇血清CAl25明显高于正常妊娠组。     

血清CA125检测在早期先兆流产妊娠预后的价值

目的探讨血清CA125检测在预测早期先兆流产妊娠预后的价值。方法采用电化学发光法对120例早期先兆流产及50例正常早孕妇女血清CA125进行测定。结果先兆流产继续妊娠组、妊娠失败组及对照组血清CA125含量分别为(22.32±9.59)U/ml、(81.69±30.65)U/ml、(10.68±4.96)U/ml,先兆流产妊娠失败组血清CA125含量明显高于正常对照组和先兆流产继续妊娠组(P0.01)。结论单次测定血清CA125水平对预测早期先兆流产的妊娠预后有一定的参考价值。     

血清孕酮、HCG对先兆流产患者临床结局预测价值研究

目的:探讨血清孕酮、HCG对先兆流产患者临床结局预测价值。方法:选择2016年2月至2019年1月在我院接受治疗的105例早期先兆性流产患者(观察组)及同期健康孕妇105例进行研究。孕妇入组后均抽取空腹外周静脉血行血清孕酮、β亚单位人绒毛膜促性腺激素(β-human choionic gonadotophin,β-HCG)测定。观察组产妇行常规保胎治疗,根据保胎治疗结果分为继续妊娠组(n=83)与妊娠失败组(n=22)。入组后对比不同组及不同保胎结局孕妇血清孕酮、β-HCG水平,并以ROC曲线分析各指标诊断效能。结果:对照组孕妇孕酮及β-HCG水平明显高于观察组(P0.05)。继续妊娠组孕妇孕酮及β-HCG水平均明显高于妊娠失败组(P0.05)。孕酮对先兆流产患者妊娠失败预测cut-off值为15.73μg·kg-1,AUC为0.809,95%CI为0.711～0.908,灵敏度为74.70%(62/83),特异度为50.00%(11/22);β-HCG对先兆流产患者妊娠失败预测cut-off值为1583.29m IU·ml-1,AUC为0.724,95%CI为0.610～0.838,灵敏度为79.52%(66/83),特异度为45.45%(10/22);联合诊断灵敏度为90.36%(75/83),特异度为81.82%(18/22),均显著高于各指标单独检验(P0.05)。结论:血清孕酮、β-HCG对先兆流产患者妊娠失败具有加高的预测价值,联合检测可提高诊断效能。     

妊娠4～9周孕妇血清hCG、E2水平与先兆流产的相关性分析

目的分析妊娠4～9周孕妇血清人绒毛膜促性腺素(hCG)、雌二醇(E_2)水平与先兆流产的相关性。方法回顾性分析我院2015年6月至2017年6月收治妊娠4～9周先兆流产孕妇和正常孕妇临床资料,根据临床资料将146例先兆流产孕妇设为研究组,进一步分成妊娠失败组(n=42)和妊娠成功组(n=104),154例正常孕妇为对照组。比较所有孕妇不同孕周hCG、E_2和孕酮(P)水平变化,同时分析hCG、E_2和P三者串联或并联诊断先兆流产孕妇妊娠结局确诊率。结果三组孕妇血清中hCG和E_2水平均随着孕周增加而逐渐上升,妊娠失败组和妊娠成功组孕妇妊娠4～9周血清hCG和E_2水平均显著低于对照组,三组之间差异具有统计学意义(P <0.05);妊娠失败组,妊娠成功组和对照组孕妇妊娠4～9周血清P水平依次降低,且三组之间差异具有统计学意义(P <0.05);三者联合诊断时,串联诊断时其特异性较高(94. 32%),并联诊断时灵敏度较好(96.53%)。结论妊娠4-9周先兆流产孕妇体内血清hCG、E_2等激素水平下降,其对随后孕妇保胎治疗和妊娠结局预测具有指导意义,值得重点关注。     

E2、P、hCG水平对药流后异常子宫出血的临床意义

目的 探讨雌二醇(E2)、孕酮(P)、人绒毛膜促性腺激素(hCG)水平对药流后异常子宫出血的临床意义.方法 选择2013年1月至2016年1月到我院妇产科收治的自愿要求进行药物终止妊娠的妇女500例,将药物流产后子宫出血时间≤14d作为正常组(n =250),＞14d作为异常组(n =250),选取同期我院妇产科收治的自愿要求手术流产400例妇女作为对照组.比较3组妇女不同时间点的E2、P、hCG水平.结果 3组妇女血清E2水平均呈上升趋势,其中异常组与正常组比较差异无统计学意义(P＞0.05);异常组血清P水平显著高于对照组(P＜0.05);异常组血清hCG水平显著高于对照组和正常组(P＜0.05).结论 药流后异常子宫出血妇女血清的P、hCG水平均异常,与E2无关,因此联合监测P、hCG水平有利于药物流产后异常子宫出血的预测和治疗.     

HE4和CA125联合检测对卵巢癌的诊断价值

探讨人附睾上皮分泌蛋白4(HE4)和糖链抗原125(CA125)联合检测对卵巢癌的诊断价值。方法分别检测卵巢癌(n=37例)和妇科良性疾病(n=38例)患者血清HE4和CA125的表达水平,同时选择40例门诊体检妇女作为对照组。结果卵巢癌组血清HE4、CAl25表达水平明显高于良性疾病组和对照组(<0.05),良性疾病组血清CAl25表达水平明显高于对照组(< 0.05);联合检测血清HE4、CA125表达水平的敏感性均高于两种指标单独检测。结论HE4和CA125联合检测可明显提高卵巢癌诊断的敏感性,值得临床推广应用。     

卵巢癌和胰腺癌患者血清CA125、CA199的水平相关分析

目的:研究血清CA125和CA199的测定对卵巢疾病和胰腺疾病诊断的临床意义.方法:发光免疫分析测定了50例正常对照组,95例卵巢疾病和67例胰腺疾病患者血清中CA125和CA199的水平.结果:卵巢癌与胰腺癌患者的血清CA125和CA199水平较对照组显著升高(P＜0.001).结论:血清CA125和CA199联合测定对诊断和鉴别卵巢癌和胰腺癌有一定的临床价值.     

血清β-HCG、P、E2和CA125对异位妊娠诊疗的价值

本文通过对异位妊娠患者和宫内正常妊娠同时监测β-HCG、孕酮（P）；对保守治疗成功与失败者检测E2、CA125水平，探讨血清学指标在异位妊娠诊断及治疗中的应用。     

卵巢癌患者手术治疗前后血清CA125、Hcy和HE4检测的临床意义

目的：探讨卵巢癌患者手术治疗前后血清CA125、Hcy和HE4水平的变化及临床意义。方法：应用放射免疫分析、酶联法和免疫法对38例卵巢癌患者进行了手术治疗前后血清CA125、Hcy和HE4检测,并与35名正常健康人作比较。结果：卵巢癌患者在手术治疗前血清CA125、Hcy和HE4水平均非常显著地高于正常人组（P〈0.01）,术后6个月未复发的33例明显下降接近于正常人组,而复发的5例,其值又回升至手术前水平（P〈0.01）。结论：检测卵巢癌患者手术治疗前后血清CA125、Hcy和HE4水平的变化有助于诊断和疗效观察。此外,该类实验室标志物更适用作为参考。     

卵巢癌患者治疗前后血清CEA、CA125、CA724水平的临床意义

本文选用3种常用且较有价值的肿瘤标志物,癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原724（CA724）,对其在卵巢癌治疗前后血清中的水平进行检测并比较,以探讨3种标志物在卵巢癌中的临床意义。     

Failed oocyte retrieval in in-vitro fertilization with documented positive serum {beta}-human chorionic gonadotrophin (HCG) concentration on day HCG+1

No oocytes were obtained at ovum retrieval in a 33-year-oldpatient with secondary tubal infertility, whereas in a previouscycle nine oocytes were obtained under the same ovarian stimulationprotocol as used in the studied cycle. Oocyte retrieval failedin spite of the correct administration of human chorionic gonadotrophin(HCG) as demonstrated by serum -HCG concentration (58.6 mIU/ml)on day HCG+1. However, it was shown that progesterone failedto rise even after the administration of exogenous HCG as theluteinizing hormone signal. Therefore, when ovum retrieval fails,the serum progesterone as well as -HCG concentrations may beuseful to help identify the cause of this unusual event.     

血清CA-125水平与妊娠先兆流产预后的关联分析

目的探讨早期正常妊娠及先兆流产孕妇血清糖类抗原125（CA-125）水平的变化,讨论其对妊娠预后的预测价值。方法对97例单胎早孕孕妇的临床资料进行回顾性分析。孕妇均为正常妊娠,无先兆流产病史。其中,正常妊娠32例,先兆流产继续妊娠38例,先兆流产妊娠失败27例。动态监测CA-125水平,比较分析监测指标的意义。结果先兆流产妊娠失败组孕妇的CA-125水平显著高于正常妊娠组和先兆流产继续妊娠组（P〈0．05）。结论血清CA-125的水平检测对妊娠的预后判断有较高的临床应用价值。     

The impact of dydrogesterone supplementation on serum cytokine profile in women with threatened abortion

PROBLEM: The role of increased Th1 cytokine expression in pregnancy failure has been questioned recently. The therapeutic value of progestogens in threatened abortion (TA) is still debated. The aim of this prospective study was to compare serum cytokine [tumor necrosis factor (TNF)-alpha, interleukin (IL)-12 and IL-10] concentrations in women with TA to those in women with normal pregnancy and to evaluate the impact of dydrogesterone supplementation in the former group on cytokine concentration. METHODS OF STUDY: Twenty-seven threatened aborters were treated for 10 days with dydrogesterone (30-40 mg/day). Sixteen healthy pregnant controls received no treatment. Serum cytokine concentrations were measured twice in both groups by enzyme-linked immunosorbent assay. RESULTS: Mean serum concentrations of Th1- and Th2-type cytokines in women with TA did not differ from those in women with normal pregnancy at first and second sampling. After dydrogesterone supplementation, mean TNF-alpha/IL-10 ratio changed from 1.08 to 1.75 while IL-12/IL-10 ratio remained almost the same (0.56-0.61) in the threatened aborters group and did not differ from those in healthy women. CONCLUSIONS: The results of this study indicate that peripheral cytokine production in threatened aborters does not differ from that observed among healthy pregnant women. The protective effect of dydrogesterone supplementation in threatened aborters is manifested via restoring progesterone-induced blocking factor concentration rather than controlling cytokine production.     

Improved sensitivity and specificity of a single measurement of serum progesterone over serial quantitative beta-human chorionic gonadotrophin in screening for ectopic pregnancy.

The sensitivity and specificity of a single serum progesterone measurement was compared against two beta-human chorionic gonadotrophin (HCG) measurements 48 h apart in screening for abnormal pregnancy, i.e. ectopic pregnancy, completed or incomplete abortion. Of 1120 patients in the first trimester presenting with a positive urinary pregnancy test, 116/1120 (10.4%) had an ectopic pregnancy, 755/1120 (67.4%) had ultrasonographically confirmed intra-uterine pregnancies, and 249/1120 (22.2%) had abnormal intra-uterine pregnancies documented as complete, incomplete or missed abortions. Of the ectopic pregnancies, 113/116 (97.4%) had a serum progesterone level less than 25 ng/ml while 516/755 (68.3%) viable intra-uterine pregnancies had a serum progesterone level greater than or equal to ng/ml. Of the 1120 patients screened, 402 (35.9%) had both a serum progesterone and two HCG measurements and were eligible for inclusion in this study. Setting a cut-off of 25 ng/ml, the sensitivity and specificity of a single serum progesterone measurement was then compared against two serial HCG measurements, utilizing receiver operating characteristic curves. This analysis demonstrated that a single serum progesterone measurement was significantly more sensitive (P less than 0.05) than two HCG measurements in screening for an abnormal pregnancy. In some patients, a single serum progesterone makes possible the diagnosis of ectopic pregnancy 2 days earlier than two HCG determinations because a second blood sample was not required. We conclude that a single serum progesterone measurement should be added to serial HCG determinations as a standard diagnostic screening test for ectopic pregnancy.     

阿托西班与盐酸利托君联合使用在晚期先兆流产及先兆早产治疗中的意义

目的观察阿托西班与盐酸利托君联合使用在晚期先兆流产及先兆早产治疗中的意义。方法对本院157例先兆流产或先兆早产且需要长期或大剂量使用宫缩抑制剂的患者进行回顾性研究。其中盐酸利托君单药使用者有108例（利托君单药组）,盐酸利托君与阿托西班联合使用者49例（联合用药组）。比较利托君单药组与联合用药组利托君使用的平均剂量及药物总量,以及两组患者妊娠延长天数及新生儿预后。另外对两组患者用药时相关的生命体征（包括心率、呼吸频率）及不良反应（包括心悸、胸闷、头痛）发生率进行对比。结果利托君单药组及联合用药组在延长妊娠天数、胎儿丢失率、新生儿出生体重及新生儿出生1min Apgar评分方面差异无统计学意义（P〉0.05）,但联合用药组的平均利托君用量及药物总量明显低于利托君单药组,孕妇平均心率及临床副作用均低于利托君单药组,差异有统计学意义（P〈0.05）。结论对需要长期或大量使用盐酸利托君抑制宫缩的先兆流产或先兆早产患者,如联合阿托西班一同使用,可降低利托君的药物用量,明显降低临床副作用。     

The impact of dydrogesterone supplementation on hormonal profile and progesterone-induced blocking factor concentrations in women with threatened abortion

PROBLEM: The therapeutic value of progestogens in threatened abortion is still under debate. In the presence of sufficient progesterone levels during pregnancy, lymphocytes synthesize a mediator [progesterone-induced blocking factor (PIBF)] that is anti-abortive in mice. The aim of this study was to evaluate the effect of dydrogesterone on pregnancy outcome of threatened aborters. METHOD OF STUDY: Twenty-seven threatened aborters were treated for 10 days with dydrogesterone (30-40 mg/day). Sixteen healthy pregnant controls received no treatment. Serum progesterone and estradiol concentrations as well as urine PIBF concentrations were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Pregnancy outcomes in dydrogesterone-treated threatened aborters did not statistically differ from those in healthy controls. Serum progesterone concentrations in control patients, but not those in threatened aborters increased as pregnancy progressed. Following dydrogesterone treatment, initially low PIBF concentrations of threatened aborters significantly increased (P = 0.001) to reach the PIBF level found in healthy controls. CONCLUSIONS: These data suggest that by inducing PIBF production, dydrogesterone might improve pregnancy success rates in threatened aborters.     

卵巢癌标志物CA125酶联免疫吸附分析法的建立

目的：建立一种血清ＣＡ１２５的临床检测方法。方法：一株ＣＡ１２５单抗用于固相包被，另一株与辣根过氧化物酶偶联制备ＣＡ１２５的酶标记物，以四甲基联苯胺为底物，采用一步法，建立了ＣＡ１２５的酶联免疫吸附分析法。结果；灵敏度为２．００Ｕ／ｍｌ。批内ＣＶ值低于５．３２％，批间ＣＶ值低于７．３９％。     

The effect of hysterectomy on serum CA 125 levels in patients with adenomyosis and uterine fibroids

The human endometrium has been reported to release CA 125 intissue culture, and elevated levels have been found in patientswith endometriosis and adenomyosis. The serum levels of CA 125were measured in 22 women undergoing hysterectomy for adenomyosis(n = 11) or fibroids (n = 11) of the uterus. In 20 patients(91%) the pre-operative CA 125 level was normal (<35 U/ml).All patients with adenomyosis had a normal pre-operative serumCA 125 concentration. Five weeks after the operation the CA125 levels did not differ from the pre-operative levels. Ourresults show that the uterine contribution to the serum CA 125level is minimal, and do not confirm the initial enthusiasmconcerning the possible use of levels as an aid in the diagnosisof adenomyosis.     

Maternal serum levels of pro-inflammatory cytokines in missed and threatened abortion

PROBLEM: A study of association between pro-inflammatory cytokines, and missed and threatened abortions with good outcome has been performed. METHOD OF STUDY: The presence of pro-inflammatory cytokines, namely interleukin (IL)-8 and IL-12 and the soluble interleukin-2 receptor (SIL-2R) was investigated in maternal serum of 12 patients with threatened abortion twice (at admission and discharge), 14 patients with missed abortion, 14 women with healthy first-trimester pregnancy, and 14 normal non-pregnant women, using specific enzyme-linked immunosorbent assays. RESULTS: SIL-2R and, in particular, IL-12 was detected with significantly higher levels in missed abortion group compared with all other groups. IL-8 was detected with no significant difference among all the groups studied. CONCLUSIONS: In spite of caution due to the small sizes of the subject samples, these results support a role of the immune system in the first trimester pregnancy and hypothesize that missed abortion may be associated with an enhanced Th1 reactivity, whereas threatened abortion with good outcome resembles the normal pregnancy with a non-enhanced Th1 reactivity.