血绒毛膜促性腺激素值对早期妊娠结局的诊断价值

目的:探讨血β-绒毛膜促性腺激素(β-HCG)值对判断早期妊娠结局的临床意义。方法:对停经6~7周、尿HCG检查阳性、B超检查宫内未见妊娠囊的妊娠者60例(研究组),进行血β-HCG首次测定及72 h后再次测定,与同期正常妊娠者30例(对照组)进行对比。结果:研究组中,首次测定血β-HCG值<1 000 m IU/m l 38例、>1 000 m IU/m l 15例、>4 000 m IU/m l 7例。对照组30例均大于4 000 m IU/m l。72 h后再次测定血β-HCG值呈倍数上升者,研究组14例,对照组30例。研究组不良妊娠结局为95%(57/60),其中流产发生率为65%(39/60),宫外孕发生率为30%(18/60),宫内早期妊娠为5%(3/60)。对照组无不良妊娠结局。首次测定血β-HCG值的平均值在两组间有非常显著性差异(P<0.001)。再次测定血β-HCG的值,呈倍数上升者在两组间有非常显著性差异(P<0.001)。结论:β-HCG首次测定值及再次测定值的倍数上升关系,对B超检查宫内未见妊娠囊的早期妊娠者,具有判断异常或正常妊娠结局的临床价值。

Diagnostic value of serumβ- Human Chorionic Gonadotropin on early pregnancy outcome

Objective:To explores the clinical diagnosis significance of β-Human Chorionic Gonadotropin(β-HCG) on early pregnancy outcomes..Methods:Initial β-HCG test and retest 72 hours after the first ones were conducted on 60 pregnancy cases(as the study group) 6-7 weeks from menopause,with urine β-HCG positive and without signs of gestational sac when checked by Ultrasound B..Comparison with 30 normal pregnancies(as the contrast group) was made to judge the pregnancy outcomes..Results:Among the 60 cases of the study group,the initial β-HCG test shown that 38 subjects' β-HCG levels were below 1000mIU/ml,15 higher than 1000mIU/ml and 7 higher than 4000mIU/ml.β-HCG levels of all the 30 subjects from the contrast group were higher than 4000mIU/ml.β-HCG levels of 14 subjects from the study group and 30 subjects from the contrast group had multiplied 72 hours later.The poor pregnancy rate was 95%(57/60),the miscarriage incidence was over 65%(39/60),and the ectopic pregnancy incidence 30%(18/60),the early intrauterine pregnancy rate was 5%(3/60) in the study group.For the contrast group,no poor pregnancy outcomes had been detected.The difference of β-HCG average values between the two groups was remarkable as a result of the initial tests(P<0.001).Also,the retest results indicated that the multiple increases of β-HCG levels of the two groups were also different from each other(P<0.001).Conclusion:The multiple increases of β-HCG test provide clinical reference for judging normal or abnormal pregnancy outcomes especially for those early pregnancies showing no intrauterine gestation sacs under Ultrasound B detection..