动态监测抑制素A在预测早期先兆流产结局中的临床意义

目的:探讨动态监测血清、尿抑制素A(InhibinA)在预测早期先兆流产结局中的临床意义及与孕酮(Proges-terone,P)、β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)的相关性。方法:观察2007年1月至2007年11月在苏州大学附属第一医院妇科门诊就诊的孕5～12周妇女64例,其中20例正常早孕,30例因黄体功能不全引起的早期先兆流产及14例难免流产患者。采用双位酶联免疫吸附法(ELISA)测定血清抑制素A、孕酮、β-HCG及晨尿抑制素A。结果:成功妊娠者血清抑制素A、P及β-HCG浓度明显高于失败结局者,差异有统计学意义(P0.05)。推荐血清抑制素A154.95pg/ml作为预测早期先兆流产保胎成功的有效指标,预测价值高于孕酮和β-HCG。正常妊娠,孕8～10周晨尿中可检测到较低浓度的抑制素A。用黄体酮和/或HCG保胎治疗并不影响母体血清抑制素A、孕酮及β-HCG水平。结论:妊娠早期低浓度血清抑制素A有助于预测先兆流产孕妇不良妊娠结局。当血清抑制素A154.95 pg/ml可作为预测早期先兆流产保胎成功的有效指标。

Clinical significance of dynamic monitoring of inhibin A in prediction of outcomes of early threatened abortion

Objective:To explore the clinical significance of dynamic monitoring of inhibin A in serum and urine in prediction of outcomes of early threatened abortion,analyze the correlation between inhibin A and progesterone,β-human chorionic gonadotropin(β-HCG).Methods:64 pregnant women of 5～12 gestational weeks from January 2007 to November 2007 were observed,including 20 women of normal pregnancy,30 women of early threatened abortion induced by luteal phase deficiency and 14 women of inevitable abortion.The levels of inhibin A in serum and morning urine,progesterone and β-human chorionic gonadotropin in serum were detected by ELISA.Results:The serum levels of inhibin A,progesterone and β-HCG in success pregnancy group were significantly lower than those in fail pregnancy group(P<0.05).Compared with progesterone and β-HCG,the serum level of inhibin A>154.95 pg/ml was recommended as the effective indicator of successful fetus protection for women with early threatened abortion.Very low level of inhibin A in morning urine was detected in normal pregnant women of 8～10 gestational weeks.Progesterone and/or HCG didn't affect the serum levels of inhibin A,progesterone and β-HCG in pregnant women.Conclusion:The low level of inhibin A in serum in early pregnancy contribute to predict the adverse pregnancy outcomes of women with early threatened abortion,the serum level of inhibin A>154.95 pg/ml can be used as an effective indicator of successful fetus protection for women with early threatened abortion.