甲氨蝶呤治疗145例异位妊娠回顾性分析

目的：为临床合理应用甲氨蝶呤（MTX）治疗异位妊娠提供理论依据。方法：回顾性分析2002～2008年江苏省人民医院妇产科145例患者应用MTX治疗的临床资料。结果：在治疗前血人绒毛膜促性腺激素（β-hCG）水平低于1 000 U/L时,单次治疗和8 d疗法的疗效差异无统计学意义（P〉0.05）,补充治疗率和副反应发生率均无明显差异（P〉0.05）。8 d疗法的疗效在血β-hCG≤1 000 U/L组和1 000～2 000 U/L组之间差异无统计学意义（P〉0.05）,但均较血β-hCG〉2 000 U/L组高,前两组转手术治疗率差异无统计学意义（P〉0.05）,但均低于最后一组。结论：当血β-hCG水平低于1 000 U/L时,推荐使用MTX单次治疗;血β-hCG水平高于2 000 U/L时MTX疗效降低,且转手术治疗几率增加。

Retrospective analysis of MTX treatment on 145 cases of ectopic pregnancy

Objective：To apply for the clinical use of Methotrexate in treatment of ectopic pregnancy,and provide a theoretical basis.Methods：Clinical data of 145 cases of ectopic pregnancy treated with MTX in Jiangsu Provincial People’s Hospital from 2002 to 2008 was retrospectively analyzed.Results：Before treatment,serum β-hCG levels were below 1000 U/L,and there was no significant difference between the single treatment and 8 d therapy,additional treatment rates and the incidence rate of adverse reactions were not significantly different.No significant difference was found between the blood β-hCG ≤1 000 U/L group and 1 000-2 000 U/L group in 8 d therapy,but higher than β-hCG〉2 000 U/L group.There was also no significant difference between the two groups of transfer rates of surgery,but all lower than the last group.Conclusion：When the blood β-hCG levels are below 1 000 U/L,the single MTX treatment should be recommended.When serum β-hCG levels are above 2 000 U/L,the MTX efficacy is reduced and increased risk of transfer surgery.