血清β-HCG联合孕酮在异位妊娠早期诊断中的应用

白素芳1，刘云婷1，张伟芬2

(1.张家口市康保县人民医院，河北 张家口 076650；2.张家口市万全县医院，河北 张家口 076250)

摘要：目的回顾性分析血清绒毛膜促性腺激素β亚单位(β-HCG)联合孕酮检测在异位妊娠(EP)早期诊断中的价值。方法选取50例异位妊娠患者作为治疗组，并设同期正常早孕孕妇50例作为对照组，2组受试者分别于孕龄30、40、50 d清晨空腹抽取静脉血5 mL，采用放射免疫法检测β-HCG和孕酮水平，观察2组血清β-HCG和孕酮水平变化，血清β-HCG联合孕酮测定与单独β-HCG测定对EP的特异度、敏感度及诊断符合率。结果2组孕龄第30天β-HCG水平比较无统计学意义(P>0.05)，治疗组孕酮低于对照组，有统计学意义(P<0.05);孕龄第40天、50天β-HCG和孕酮水平治疗组显著低于对照组(P<0.05)；血清β-HCG联合孕酮测定对EP的特异度、敏感度及诊断符合率明显高于单独β-HCG测定，P<0.05。结论血清β-HCG联合孕酮检测对EP的诊断符合率明显较单项β-HCG检测占优势，尤其对症状和体征不典型的早孕患者，可弥补单项β-HCG检测的不足，可为临床早期治疗赢得时间。

关键词：异位妊娠；血清绒毛膜促性腺激素β亚单位；孕酮；早期诊断

DOI:10.13463/j.cnki.cczyy.2015.06.066

中图分类号：R271.9文献标志码：A

文章编号：2095-6258(2015)06-1277-03

基金项目：河北省张家口市计划外科研课题(2015)。

作者简介：白素芳(1977-)，大学本科，主治医师，主要从事产科危重症治疗。

收稿日期:(2015-08-31)

Serum β-HCG combined with progesterone assay in early diagnosis of ectopic pregnancy

BAI Sufang1, LIU Yunting1, ZHANG Weifen2

(1. People’s Hospital of Kangbao County, Zhangjiakou 076650, Hebei Province, China;

2. People’s Hospital of Wanquan County, Zhangjiakou 076250, Hebei Province, China)

Abstract：ObjectiveTo explore the value of serum β-HCG combined with progesterone assay in early diagnosis of ectopic pregnancy (EP). MethodsA total of 50 EP patients as the observation group, while 50 early pregnant women at the same stage were served as the control group. A volume of 5mL morning fasting venous blood in the two groups at gestational age of 30d, 40d and 50d was extracted. RIA was used to detect the levels of β-HCG and progesterone. The changes of serum β-HCG and progesterone levels were observed. The specificity, sensitivity, and diagnostic accordance rate by the combination determination or a single β-HCG determination were detected. ResultsThe comparison of β-HCG level at gestational age of 30d between the two groups was not statistically significant (P>0.05), while the progesterone level in the observation group was significantly lower than that in the control group (P<0.05). The β-HCG and progesterone levels at gestational age of 40d and 50d in the observation group were significantly lower than those in the control group (P<0.05). The specificity, sensitivity, and diagnostic accordance rate by the combination determination were significantly higher that those by a single β-HCG determination (P<0.05). ConclusionThe diagnostic accordance rate of EP by serum β-HCG in combined with progesterone assay is significantly superior to that by a single β-HCG determination, especially in the early pregnant women with atypical symptoms and signs, the combination determination can compensate for the deficiency by a single β-HCG determination, and is of great significance in the diagnosis of an early EP, thus, gaining time for an early treatment in the clinic.

Keywords：ectopic pregnancy; serum β-HCG; progesterone; early diagnosis

异位妊娠(EP)受精卵在子宫腔以外部位着床，易引发破裂引起腹腔内大出血，导致出血性休克，危及孕妇生命，为临床妇产科急腹症之一，其中输卵管妊娠约占95%。本病发病率近年趋于年轻化，并呈上升趋势，严重影响育龄期女性的生命安全，所以早期诊断及治疗具有重要意义[1-4]。本研究回顾分析EP患者和正常宫腔内妊娠孕妇的β-HCG及孕酮水平变化，以探讨其对EP早期诊断的临床意义。

1资料与方法

1.1一般资料选取2014年2月—2015年2月我科收治的50例EP患者作为治疗组，年龄21～43岁，平均(26.6±8.5)岁；孕龄……