血清孕酮\β-HCG联合检测在早期先兆流产治疗中的临床价值(1)
[摘要] 目的 分析研究血清孕酮、人绒毛膜促性腺激素(β-HCG)联合检测在早期先兆流产治疗中的临床价值。 方法 对本院收治的116例早期先兆流产患者的血清孕酮及β-HCG水平进行检测，分析不同孕酮及β-HCG水平对患者妊娠结局的影响。 结果 孕酮>25.00 ng/ml，β-HCG>50 mIU/ml的患者均可保胎成功继续妊娠；孕酮为15.94～25.00 ng/ml，β-HCG为10～50 mIU/ml的患者经积极治疗后可保胎成功继续妊娠；孕酮<15.94 ng/ml，β-HCG<10 mIU/ml以及孕酮和β-HCG不同步的患者，即使积极进行治疗最终仍难免流产，终止妊娠。 结论 血清孕酮和β-HCG联合检测可准确评估早期先兆流产患者的预后，可根据孕酮和β-HCG检测水平对患者进行针对性治疗，有效地避免医源性浪费和减少稽留流产的发生。
[关键词] 早期先兆流产；血清孕酮；血清人绒毛膜促性腺激素
[中图分类号] R714.21[文献标识码] B[文章编号] 1674-4721(2014)05(a)-0153-03
Clinical value of joint detection of serum progesterone and β-HCG in the treatment of early threatened abortion
ZHANG Hui-hua LI Lian
Dinghu District People′s Hospital in Zhaoqing City of Guangdong Province,Zhaoqing 526070,China
[Abstract] Objective To analyze and study the clinical value of joint detection of serum progesterone and human chorionic gonadotropin (β-HCG) in the treatment of early threatened abortion.Methods Levels of serum progesterone and β-HCG from 116 cases of patients with early threatened abortion admitted into our hospital were detected,the influence on pregnancy outcome by different levels of progesterone and β-HCG was analyzed.Results Patients whose level of progesterone was over 25.00 ng/ml and β-HCG over 50 mIU/ml could successfully prevent miscarriages and continue pregnancy.Patients whose level of progesterone was 15.94-25.00 ng/ml,and β-HCG 10-50 mIU/ml could also successfully prevent miscarriages and continue pregnancy after active treatment.Patients whose level of progesterone was less than 15.94 ng/ml and β-HCG below 10 mIU/ml or discrepant of progesterone and β-HCG levels hardly could avoid miscarriages and finally led to termination of pregnancy,even if active treatment was adopted.Conclusion Joint detection of serum progesterone and β-HCG can accurately evaluate the prognosis of early threatened abortion patients.Targeted treatment based on the detected levels of progesterone and β-HCG can effectively avoid iatrogenic waste and reduce occurrence of missed abortion.
[Key words] Early threatened abortion;Serum progesterone;Serum human chorionic gonadotropin
先兆流产常见于妇产科，其发病原因较多。对早期先兆流产患者的妊娠结局进行准确的评估预测，有利于医生对患者及时地采取相应的治疗措施，可有效提高保胎成功率，并减少不必要的医源性浪费和稽留流产[1]。而在短时间内利用简便有效的方法准确地对先兆流产预后进行评估，则成为近年妇产科医生高度关注的焦点。本研究探讨血清孕酮、人绒毛膜促性腺激素(β-HCG)联合检测在早期先兆流产治疗中的临床价值。
1 资料与方法
1.1 一般资料
选取2010年6月～2013年6月本科收治的116例早期先兆流产患者，年龄20～36岁，平均(28.2±2.5)岁，停经时间42～70 d，平均(52.1±2.7) d；流产史1次者32例，≥2次者24例；患者临床表现为停经后均有阴道少量流血，多伴轻微腹痛，检查发现患者宫颈口闭，为来自于宫腔的阴道流血。
1.2 选取标准
所选取的患者均为宫内单胎妊娠，排除子宫附件异常、严重心肝肾等重要器官疾病或严重的器质性疾病患者。
1.3 检测方法
所有研究对象均抽取肘5 ml静脉血，并进行离心，实施血清分离后，将其放置于-20℃冰箱中进行冰冻保存待检。采用放射学免疫分析法(RIA)检测β-HCG，采用电化学发光法(ECL)检测孕酮。
1.4 治疗方法
参考每位患者检测所得的孕酮及β-HCG结果分别进行不同的保胎治疗或建议终止妊娠。①对孕酮>25.00 ng/ml，β-HCG>50 mIU/ml的患者，可考虑为非内分泌异常所致的先兆流产，可不予药物治疗，嘱孕妇绝对卧床休息保胎；②对孕酮为15.94～25.00 ng/ml，β-HCG为10～50 mIU/ml的患者，嘱孕妇绝对卧床休息，如B超未见孕囊有异常改变，予肌注黄体酮(广州白云山明兴制药有限公司，批号：130703)20 mg每天1次及肌内注射HCG(丽珠集团丽珠制药厂，批号：131207)2000 U隔天1次；③对孕酮<15.94 ng/ml，β-HCG<10 mIU/ml的患者，孕妇绝对卧床休息，肌内注射黄体酮及HCG保胎治疗，如B超提示孕囊发育不正常，则无保胎价值，建议终止妊娠。, 百拇医药(张辉华 李濂)
[关键词] 早期先兆流产；血清孕酮；血清人绒毛膜促性腺激素
[中图分类号] R714.21[文献标识码] B[文章编号] 1674-4721(2014)05(a)-0153-03
Clinical value of joint detection of serum progesterone and β-HCG in the treatment of early threatened abortion
ZHANG Hui-hua LI Lian
Dinghu District People′s Hospital in Zhaoqing City of Guangdong Province,Zhaoqing 526070,China
[Abstract] Objective To analyze and study the clinical value of joint detection of serum progesterone and human chorionic gonadotropin (β-HCG) in the treatment of early threatened abortion.Methods Levels of serum progesterone and β-HCG from 116 cases of patients with early threatened abortion admitted into our hospital were detected,the influence on pregnancy outcome by different levels of progesterone and β-HCG was analyzed.Results Patients whose level of progesterone was over 25.00 ng/ml and β-HCG over 50 mIU/ml could successfully prevent miscarriages and continue pregnancy.Patients whose level of progesterone was 15.94-25.00 ng/ml,and β-HCG 10-50 mIU/ml could also successfully prevent miscarriages and continue pregnancy after active treatment.Patients whose level of progesterone was less than 15.94 ng/ml and β-HCG below 10 mIU/ml or discrepant of progesterone and β-HCG levels hardly could avoid miscarriages and finally led to termination of pregnancy,even if active treatment was adopted.Conclusion Joint detection of serum progesterone and β-HCG can accurately evaluate the prognosis of early threatened abortion patients.Targeted treatment based on the detected levels of progesterone and β-HCG can effectively avoid iatrogenic waste and reduce occurrence of missed abortion.
[Key words] Early threatened abortion;Serum progesterone;Serum human chorionic gonadotropin
先兆流产常见于妇产科，其发病原因较多。对早期先兆流产患者的妊娠结局进行准确的评估预测，有利于医生对患者及时地采取相应的治疗措施，可有效提高保胎成功率，并减少不必要的医源性浪费和稽留流产[1]。而在短时间内利用简便有效的方法准确地对先兆流产预后进行评估，则成为近年妇产科医生高度关注的焦点。本研究探讨血清孕酮、人绒毛膜促性腺激素(β-HCG)联合检测在早期先兆流产治疗中的临床价值。
1 资料与方法
1.1 一般资料
选取2010年6月～2013年6月本科收治的116例早期先兆流产患者，年龄20～36岁，平均(28.2±2.5)岁，停经时间42～70 d，平均(52.1±2.7) d；流产史1次者32例，≥2次者24例；患者临床表现为停经后均有阴道少量流血，多伴轻微腹痛，检查发现患者宫颈口闭，为来自于宫腔的阴道流血。
1.2 选取标准
所选取的患者均为宫内单胎妊娠，排除子宫附件异常、严重心肝肾等重要器官疾病或严重的器质性疾病患者。
1.3 检测方法
所有研究对象均抽取肘5 ml静脉血，并进行离心，实施血清分离后，将其放置于-20℃冰箱中进行冰冻保存待检。采用放射学免疫分析法(RIA)检测β-HCG，采用电化学发光法(ECL)检测孕酮。
1.4 治疗方法
参考每位患者检测所得的孕酮及β-HCG结果分别进行不同的保胎治疗或建议终止妊娠。①对孕酮>25.00 ng/ml，β-HCG>50 mIU/ml的患者，可考虑为非内分泌异常所致的先兆流产，可不予药物治疗，嘱孕妇绝对卧床休息保胎；②对孕酮为15.94～25.00 ng/ml，β-HCG为10～50 mIU/ml的患者，嘱孕妇绝对卧床休息，如B超未见孕囊有异常改变，予肌注黄体酮(广州白云山明兴制药有限公司，批号：130703)20 mg每天1次及肌内注射HCG(丽珠集团丽珠制药厂，批号：131207)2000 U隔天1次；③对孕酮<15.94 ng/ml，β-HCG<10 mIU/ml的患者，孕妇绝对卧床休息，肌内注射黄体酮及HCG保胎治疗，如B超提示孕囊发育不正常，则无保胎价值，建议终止妊娠。, 百拇医药(张辉华 李濂)