CAJ | 학술논문

目的：探讨β－人绒毛膜促性腺激素（β－HCG）、孕酮、子宫内膜厚度联合检测在早期异位妊娠诊断中的价值。方法选择2005年11月至2012年11月潍坊市妇幼保健医院收治的疑似早期异位妊娠患者164例，根据妊娠结局分为异位妊娠组（异位妊娠组，64例），宫内妊娠流产组（宫内妊娠流产组，38例），正常宫内妊娠组（正常宫内妊娠组，62例），采用经阴道超声测量其子宫内膜厚度，并测定患者的血清孕酮及β－HCG值，比较3组子宫内膜厚度及血β－HCG、孕酮水平。结果异位妊娠组子宫内膜厚度（0.65±0.30） cm、β－HCG（1846±655） U／L及孕酮（20±3） nmol／L水平明显低于宫内妊娠流产组（1.04±0.32） cm、（2580±1216） U／L、（33±4） nmol／L 及正常宫内妊娠组（1.38±0.19） cm、（3211±1405） U／L、（60±14） nmol／L（P＜0.05）；在三组中子宫内膜厚度及血β－HCG、孕酮联合诊断的准确率（95.3％、92.1％、98.4％）差异均无统计学意义 P＞0.05），而单项指标判断早期异位妊娠差异有统计学意义（ P＜0.05）。相关性分析结果显示，在异位妊娠及宫内妊娠中，子宫内膜厚度与孕酮及β－HCG值均呈正相关（ P＜0.05）。结论血清孕酮及β－HCG值可判定妊娠发生，但对异位妊娠与宫内未形成孕囊的早早孕鉴别较难，配合超声检查子宫内膜厚度，可以判定孕囊的着床部位，对早期鉴别异位妊娠有重要意义。
목적：탐토β－인융모막촉성선격소（β－HCG）、잉동、자궁내막후도연합검측재조기이위임신진단중적개치。방법선택2005년11월지2012년11월유방시부유보건의원수치적의사조기이위임신환자164례，근거임신결국분위이위임신조（이위임신조，64례），궁내임신유산조（궁내임신유산조，38례），정상궁내임신조（정상궁내임신조，62례），채용경음도초성측량기자궁내막후도，병측정환자적혈청잉동급β－HCG치，비교3조자궁내막후도급혈β－HCG、잉동수평。결과이위임신조자궁내막후도（0.65±0.30） cm、β－HCG（1846±655） U／L급잉동（20±3） nmol／L수평명현저우궁내임신유산조（1.04±0.32） cm、（2580±1216） U／L、（33±4） nmol／L 급정상궁내임신조（1.38±0.19） cm、（3211±1405） U／L、（60±14） nmol／L（P＜0.05）；재삼조중자궁내막후도급혈β－HCG、잉동연합진단적준학솔（95.3％、92.1％、98.4％）차이균무통계학의의 P＞0.05），이단항지표판단조기이위임신차이유통계학의의（ P＜0.05）。상관성분석결과현시，재이위임신급궁내임신중，자궁내막후도여잉동급β－HCG치균정정상관（ P＜0.05）。결론혈청잉동급β－HCG치가판정임신발생，단대이위임신여궁내미형성잉낭적조조잉감별교난，배합초성검사자궁내막후도，가이판정잉낭적착상부위，대조기감별이위임신유중요의의。
Objective To investigate the value of β-human chorionic gonadotropin(β-HCG) ,progester-one,endometrial thickness combined detection in the early diagnosis of ectopic pregnancy.Methods A total of 164 cases with suspected ectopic pregnancy admitted to Weifang City Maternal and Child Health Hospital from Nov.2005 to Nov.2012 were divided into ectopic pregnancy group(64 cases),intrauterine pregnancy abortion group(38 cases),normal intrauterine pregnancy group(62 cases) according to the outcome of preg-nancy.The thickness of endometrium was measured by transvaginal ultrasound, serum progesterone andβ-HCG values were detected,and the value of β-HCG,progesterone,endometrial thickness combined detec-tion in the early diagnosis of ectopic pregnancy were analyzed.Results Endometrial thickness ( 0.65 ± 0.30) cm,β-HCG (1846 ±655) U/L and progesterone values(20 ±3) nmol/L of ectopic pregnancy group were significantly lower than intrauterine pregnancy abortion group (1.04 ±0.32) cm,(2580 ±1216) U/L, (33 ±4) nmol/L,and normal intrauterine pregnancy group (1.38 ±0.19) cm,(3211 ±1405) U/L,(60 ± 14) nmol/L,the differences were statistically significant(P<0.05).There was no significant differences in the combined diagnosis accuracy of intima-media thickness,serum β-HCG,progesterone in the three groups (95.3%,92.1%,98.4%,P>0.05) ,while diagnosis accuracy of single indicator of early ectopic pregnan-cy had significant differences(P<0.05).Correlation analysis showed that in the cases of ectopic pregnancy and intrauterine pregnancy,endometrial thickness,and β-HCG and progesterone values were positively corre-lated (P<0.05).Conclusion Serum progesterone andβ-HCG values can be used to detect pregnancy,but is difficult for differential diagnosis of ectopic pregnancy with intrauterine gestational sac of early pregnancy , while ultrasound endometrial thickness checking can be used to determine gestational sac implantation site , which is important for early identification of ectopic pregnancy .