CAJ | 학술논문

目的：探讨影响早孕妇女先兆流产保胎失败的相关因素。方法回顾性分析我院2008年1月至2012年12月间先兆流产住院保胎治疗的158例孕妇的临床资料，根据保胎的结局分为保胎成功组(A组)124例与保胎失败组(B组)34例，比较两组间导致早孕妇先兆流产保胎失败的因素。结果 A组的血清人绒毛膜促性腺激素(β-HCG)水平、孕酮(P)水平分别为(5140.53±920.92) mU/ml和(49.76±11.09) ng/ml，明显比B组的(3643.65±762.29) mU/ml和(36.13±6.64) ng/ml高，其差异均有统计学意义(P<0.05)。A组的孕妇年龄、孕周、抗子宫内膜抗体阳性率分别为(27.82±2.50)岁、(7.88±1.33)周和10.48%；明显比B组的(30.71±2.77)岁、9.21±0.93周和55.88%低，两组间比较差异均有统计学意义(P<0.05)。A组孕妇的孕次、产次分别为(1.77±0.73)次和(1.31±0.80)次，与B组孕妇的(1.68±0.96)次和(1.06±0.76)次相比较差异无统计学意义(P>0.05)。相关分析表明，引起先兆流产保胎失败的主要因素有孕妇年龄、孕周、β-HCG、P和抗子宫内膜抗体，而与孕妇的孕次、产次无关，其中β-HCG、P与先兆流产保胎失败的风险呈正相关(r1=0.569，P=0.000；r2=0.478，P=0.000)，抗子宫内膜抗体阳性率与先兆流产保胎失败的风险呈负相关(r3=-0.513，P=0.000)。结论对早孕妇女早期监测β-HCG、P和抗子宫内膜抗体能够早期预测先兆流产的风险，为提高保胎的效果提供临床依据。
목적：탐토영향조잉부녀선조유산보태실패적상관인소。방법회고성분석아원2008년1월지2012년12월간선조유산주원보태치료적158례잉부적림상자료，근거보태적결국분위보태성공조(A조)124례여보태실패조(B조)34례，비교량조간도치조잉부선조유산보태실패적인소。결과 A조적혈청인융모막촉성선격소(β-HCG)수평、잉동(P)수평분별위(5140.53±920.92) mU/ml화(49.76±11.09) ng/ml，명현비B조적(3643.65±762.29) mU/ml화(36.13±6.64) ng/ml고，기차이균유통계학의의(P<0.05)。A조적잉부년령、잉주、항자궁내막항체양성솔분별위(27.82±2.50)세、(7.88±1.33)주화10.48%；명현비B조적(30.71±2.77)세、9.21±0.93주화55.88%저，량조간비교차이균유통계학의의(P<0.05)。A조잉부적잉차、산차분별위(1.77±0.73)차화(1.31±0.80)차，여B조잉부적(1.68±0.96)차화(1.06±0.76)차상비교차이무통계학의의(P>0.05)。상관분석표명，인기선조유산보태실패적주요인소유잉부년령、잉주、β-HCG、P화항자궁내막항체，이여잉부적잉차、산차무관，기중β-HCG、P여선조유산보태실패적풍험정정상관(r1=0.569，P=0.000；r2=0.478，P=0.000)，항자궁내막항체양성솔여선조유산보태실패적풍험정부상관(r3=-0.513，P=0.000)。결론대조잉부녀조기감측β-HCG、P화항자궁내막항체능구조기예측선조유산적풍험，위제고보태적효과제공림상의거。
Objective To explore the relative factors of threatened abortion in women with early pregnancy. Methods Retrospective analysis was performed with clinical data from 158 in our hospital from January 2008 to De-cember 2012. According to the result of threatened abortion, they were divided into two groups, group A (successful pregnancy group, n=34), and group B (unsuccessful pregnancy group, n=34). The factors which caused the threatened abortion were compared between the two groups. Results The levels of human chorionic gonadotropin (β-HCG) and the progesterone (P) in group A were significantly higher than those in group B [(5 140.53±920.92) mU/ml vs (3 643.65 ± 762.29) mU/ml and (49.76 ± 11.09) ng/ml vs (36.13 ± 6.64) ng/ml, P<0.05]. The maternal age, gestational weeks and the positive rate of anti endometrial antibody of group A were significantly lower than that of group B [(27.82±2.50) Y vs (30.71±2.77) Y, (7.88±1.33) W vs (9.21±0.93) W and 10.48%vs 55.88%, P<0.05]. There were no significant differences between group A and group B with the pregnancy time and the production time [(1.77 ± 0.73) times vs (1.68±0.96) times and (1.31±0.80) times vs (1.06±0.76) times, P>0.05]. The correlation analysis showed that the main factors causing the failure of treatment of threatened abortion were the maternal age, gestational weeks, the level ofβ-HCG, the level of P and the positive rate of anti endometrial antibody, but no relationship was found be-tween threatened abortion with gravidity or production times. The levels ofβ-HCG and P were positively associated with the failure of treatment of the threatened abortion (r1=0.569, P=0.000;r2=0.478, P=0.000), and the positive rate of anti endometrial antibody was inversely associated with the failure of treatment of the threatened abortion (r3=-0.513, P=0.000). Conclusion Monitor the level of β-HCG, P and anti endometrial antibody of pregnant women in early stage could reduce the failure of treatment of threatened abortion, and improve the clinical effect of treatment of threat-ened abortion.