孕早期血清β-HCG、E2、P联合测定及E2／P比值的临床意义

目的探讨血清人绒毛膜促性腺激素（β-HCG）、雌二醇（E2）、孕酮（P）及雌二醇／孕酮（E2／P）在早期鉴别异位妊娠、先兆流产和难免流产中的价值。方法对105例疑诊为异常妊娠患者作血清E2、P及β-HCG测定，根据妊娠结局分异位妊娠组（D组）、先兆流产组（B组）、难免流产组（C组），65例正常宫内妊娠组，为对照组（A组）。结果D组P值明显低于宫内妊娠组（A、B及C组）（P〈0．01）；异常妊娠（B、C及D组）E2均低于A组（P〈0．01）。48h血清β-HCG动态测定，异常妊娠各组较A组上升斜率减低，倍增时间延长（P〈0．01）。D组E2／P比A组高，B组及C组E2／P比A组低（P〈0．05）。先兆流产组、难免流产组β-HCG、E2明显低于对照组（P〈0．01），E2／P比值低于对照组（P〈0．05）。结论血清β—HCG、E2、P联合测定并结合E2／P比值来鉴别孕早期异常妊娠有一定的诊断价值。

Value of Detecting Serum B-HCG,Estradiol and Progesterone in Early Diagnosis of Ectopic Pregnancy

Objective To explore the value of the serum beta human chorionic gonadotropin （β-HCG） , Estradiol （ E2 ）, Progesterone （P） and E2/P in the early difference diagnosis among ectopic pregnancy（ EP）, threatened abortion and inevitable abortion. Methods Serum P and β-HCG and E2 were assayed in 105 patients who were suspected to be EP. On the basis of pregnancy results the patients were divided into three groups： ectopic pregnancy group （group D）, threatened abortion group（ group C ） and inevitable abortion group（group B）. 65 cases of normal uterine pregnancy were as control group（group A）. Results The level of P in group D was significantly lower than that of the uterine pregnancy groups（ group A,B,C） ,P 〈0.01. The levels of E2 in abnormal pregnancy groups （group B, C, D） were all lower than that in group A, and the rising slope in abnormal pregnancy groups was reduced and their doubling time was increased according to the continuous detecting of β-HCG（P 〈 0.01 ）. The rate of E2/P of group D was significantly higher than that of group A,but Group B and C were adverse（ P 〈0.05 ）. The serum β-HCG and E2 of group B and C were significantly lower than that of group A. Conclusions Combined detecting serum P, β-HCG, E2 and E2/ P has important value in the early difference diagnosis among ectopic pregnancy,threatened abortion and inevitable abortion.