中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2015年
4期
269-273
,共5页
妊娠初期%内因素%流产,自然%孕酮%黄体保持
妊娠初期%內因素%流產,自然%孕酮%黃體保持
임신초기%내인소%유산,자연%잉동%황체보지
Pregnancy trimester,first%Intrinsic factor%Abortion,spontaneous%Progesterone%Corpus luteum maintenance
目的 探讨正常妊娠与自然流产不孕患者排卵后血清人绒毛膜促性腺激素(HCG)和孕酮水平的连续变化,孕酮水平与黄体支持治疗在妊娠初期的关系及其作用.方法 2007年1月至2011年12月在北京朝阳医院妇产科生殖医学中心接受治疗的不孕患者135例,经夫精人工授精受孕宫内单胎妊娠84个周期,自然受孕妊娠66个周期,共150个周期分为两组:顺利妊娠到20周为妊娠组(80个周期),妊娠20周以前流产为流产组(70个周期).比较两组患者的临床资料、基础血清生殖激素水平、超声监测数据和排卵后不同时间血清HCG、孕酮水平.结果 妊娠组平均年龄(30.0±3.9)岁,流产组(30.7±4.9)岁.妊娠组基础雌二醇(E2)水平为(152±66) pmol/L,促卵泡激素(FSH)/促黄体生成素(LH)比值为1.57 ±0.96,流产组基础E2水平为(147±69) pmol/L,FSH/LH比值为1.56±1.08.排卵前两组子宫内膜厚度、优势卵泡数、优势卵泡最大直径、血清激素水平比较差异无统计学意义.妊娠组排卵后14～21 d(128.1 nmol/L)、22 ～27 d(129.3 nmol/L)、28 d后(121.8 nmol/L)孕酮水平稳定,且均高于同时期流产组水平(39.9、35.2、11.7 nmol/L),差异有统计学意义(Z值分别为-4.365、-4.665、-6.687,均P＜0.01).两组使用和不使用黄体支持治疗的血清孕酮水平差异无统计学意义.结论 妊娠初期血清孕酮水平适用于评估胚胎质量,无论是否给予黄体支持治疗,不良发育胚胎的孕酮水平均表现为偏低和/或下降,是否存在临床意义临界值有待探讨,故孕酮水平不能作为指导黄体支持治疗的临床指征.
目的 探討正常妊娠與自然流產不孕患者排卵後血清人絨毛膜促性腺激素(HCG)和孕酮水平的連續變化,孕酮水平與黃體支持治療在妊娠初期的關繫及其作用.方法 2007年1月至2011年12月在北京朝暘醫院婦產科生殖醫學中心接受治療的不孕患者135例,經伕精人工授精受孕宮內單胎妊娠84箇週期,自然受孕妊娠66箇週期,共150箇週期分為兩組:順利妊娠到20週為妊娠組(80箇週期),妊娠20週以前流產為流產組(70箇週期).比較兩組患者的臨床資料、基礎血清生殖激素水平、超聲鑑測數據和排卵後不同時間血清HCG、孕酮水平.結果 妊娠組平均年齡(30.0±3.9)歲,流產組(30.7±4.9)歲.妊娠組基礎雌二醇(E2)水平為(152±66) pmol/L,促卵泡激素(FSH)/促黃體生成素(LH)比值為1.57 ±0.96,流產組基礎E2水平為(147±69) pmol/L,FSH/LH比值為1.56±1.08.排卵前兩組子宮內膜厚度、優勢卵泡數、優勢卵泡最大直徑、血清激素水平比較差異無統計學意義.妊娠組排卵後14～21 d(128.1 nmol/L)、22 ～27 d(129.3 nmol/L)、28 d後(121.8 nmol/L)孕酮水平穩定,且均高于同時期流產組水平(39.9、35.2、11.7 nmol/L),差異有統計學意義(Z值分彆為-4.365、-4.665、-6.687,均P＜0.01).兩組使用和不使用黃體支持治療的血清孕酮水平差異無統計學意義.結論 妊娠初期血清孕酮水平適用于評估胚胎質量,無論是否給予黃體支持治療,不良髮育胚胎的孕酮水平均錶現為偏低和/或下降,是否存在臨床意義臨界值有待探討,故孕酮水平不能作為指導黃體支持治療的臨床指徵.
목적 탐토정상임신여자연유산불잉환자배란후혈청인융모막촉성선격소(HCG)화잉동수평적련속변화,잉동수평여황체지지치료재임신초기적관계급기작용.방법 2007년1월지2011년12월재북경조양의원부산과생식의학중심접수치료적불잉환자135례,경부정인공수정수잉궁내단태임신84개주기,자연수잉임신66개주기,공150개주기분위량조:순리임신도20주위임신조(80개주기),임신20주이전유산위유산조(70개주기).비교량조환자적림상자료、기출혈청생식격소수평、초성감측수거화배란후불동시간혈청HCG、잉동수평.결과 임신조평균년령(30.0±3.9)세,유산조(30.7±4.9)세.임신조기출자이순(E2)수평위(152±66) pmol/L,촉란포격소(FSH)/촉황체생성소(LH)비치위1.57 ±0.96,유산조기출E2수평위(147±69) pmol/L,FSH/LH비치위1.56±1.08.배란전량조자궁내막후도、우세란포수、우세란포최대직경、혈청격소수평비교차이무통계학의의.임신조배란후14～21 d(128.1 nmol/L)、22 ～27 d(129.3 nmol/L)、28 d후(121.8 nmol/L)잉동수평은정,차균고우동시기유산조수평(39.9、35.2、11.7 nmol/L),차이유통계학의의(Z치분별위-4.365、-4.665、-6.687,균P＜0.01).량조사용화불사용황체지지치료적혈청잉동수평차이무통계학의의.결론 임신초기혈청잉동수평괄용우평고배태질량,무론시부급여황체지지치료,불량발육배태적잉동수평균표현위편저화/혹하강,시부존재림상의의림계치유대탐토,고잉동수평불능작위지도황체지지치료적림상지정.
Objective To investigate serum levels of β-human chorionic gonadotrophin (β-HCG) and progesterone (P) in early pregnant women,and their relation to luteal maintenance therapy for early pregnancy protection.Methods One hundred and thirty five infertility women treated in Department of Gynecology and Obstetrics of Beijing Chaoyang Hospital from January 2007 to December 2011.Total 150pregnancy cycles,including 84 with intrauterine insemination (IUI) and 66 with natural conception,were divided into two groups:normal intrauterine pregnancy group (group A,n =80) and early pregnancy loss group (group B,n =70).Medical history,ultrasonic findings,serum female hormone,P and β-HCG levels at early pregnancy stage were analyzed.Results The age of group A and group B was (30.0 ± 3.9) years and(30.7 ± 4.9) years,respectively (P ＞ 0.05).The follicle-stimulating hormone/luteinizing hormone in group A and group B was 1.57 ±0.96 and 1.56 ± 1.08 ; the estradiol levels in two groups were (152 ±66) pmol/L and (147 ± 69) pmol/L,respectively (both P ＞ 0.05).There were no differences in dominant follicles and endometrial thickness between groups A and B (P ＞ 0.05).Ovulation promotion and luteal support treatments were adopted in both groups:50％ (40/80) of cycles in group A received ovulation promotion,73％ (58/80) of cycles received luteal support,while 44％ (31/70) and 76％ (53/70) received in groups B,respectively.The levels of serum progesterone in group A during 14-21 d,22-27 d and ≥ 28 d after ovulation were higher than those in group B at each time points (P ＜ 0.0l).There were no significant differences in serum progesterone levels between women with luteal support treatment and those without luteal support treatment in both groups (P ＞ 0.05).Conclusion Dynamic monitoring of serum progesterone level in early pregnancy may be used as an auxiliary index for prediction of pregnancy outcome,but it may not be an indicator for luteal maintenance therapy.
