血清孕酮、β-人绒毛膜促性腺激素在早期先兆流产诊断中的应用
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摘要
目的探讨血清孕酮与β-人绒毛膜促性腺激素在早期先兆流产诊断中的应用价值。方法选取我院妇产科2016年5月～2018年2月收治的确诊为先兆流产的孕妇80例为先兆流产组,同时选取正常健康孕妇80例为健康组,检测两组孕妇血清孕酮和β-人绒毛膜促性腺激素(β-HCG)含量,分别评估孕酮和β-HCG单独检测与联合检测时的灵敏度、特异度和约登指数。结果先兆流产组孕妇血清孕酮和β-HCG含量含量显著低于正常孕妇,差异有统计学意义(P <0.05);保胎成功组孕妇血清孕酮和β-HCG含量含量显著高于保胎失败组孕妇,差异有统计学意义(P <0.05);孕酮与β-HCG联合检测先兆流产的灵敏度、特异度和准确度显著高于孕酮和β-HCG单独检测,差异有统计学意义(P <0.05);孕酮单独检测先兆流产的灵敏度、特异度和准确率与β-HCG单独检测相比差异无统计学意义(P> 0.05);孕酮单独检测的约登指数为0.47,β-HCG单独检测的约登指数为0.34,联合检测的约登指数为0.86,联合检测的约登指数>孕酮检测>β-HCG检测。结论血清孕酮、β-HCG联合检测在诊断孕妇先兆流产时具有较高的灵敏度、特异度和准确率,值得推广应用。
Objective To explore the application value of serum progesterone and β-human chorionic gonadotropin in diagnosis of early threatened abortion. Methods 80 pregnant women who were diagnosed as threatened abortion and treated in the department of obstetrics and gynecology in our hospital from May 2016 to February 2018 were selected as the threatened abortion group.80 healthy pregnant women were selected as the healthy group.Serum progesterone and β-human chorionic gonadotropin(β-HCG)levels were measured in both groups.And the sensitivity,specificity and Yodenindex of progesterone and β-HCG alone and in combination were respectively evaluated. Results Serum progesterone and β-HCG levels of pregnant women in the threatened abortion group were significantly lower than those of normal pregnant women,and the difference was statistically significant(P < 0.05).Serum progesterone and β-HCG levels in pregnant women with a successful fetus care were significantly higher than those with failed fetus care,and the difference was statistically significant(P < 0.05).The sensitivity,specificity and accuracy of progesterone combined with β-HCG in detection of threatened abortion were significantly higher than those of progesterone and β-HCG alone,and the difference was statistically significant(P < 0.05).The sensitivity,specificity and accuracy of progesterone alone in detecting threatened abortion were not statistically significantly different from those of β-HCG alone(P > 0.05).The Yoden index for progesterone alone was 0.47 and the Yoden index for β-HCG alone was 0.34.The Yoden index of combined detection was 0.86.The Yoden index of the combined detection was greater than that of the progesterone test,followed by that of the β-HCG test. Conclusion The combined detection of serum progesterone and β-HCG has higher sensitivity,specificity and accuracy in the diagnosis of pregnant women with threatened abortion,which is worthy of promotion and application.
Objective To explore the application value of serum progesterone and β-human chorionic gonadotropin in diagnosis of early threatened abortion. Methods 80 pregnant women who were diagnosed as threatened abortion and treated in the department of obstetrics and gynecology in our hospital from May 2016 to February 2018 were selected as the threatened abortion group.80 healthy pregnant women were selected as the healthy group.Serum progesterone and β-human chorionic gonadotropin(β-HCG)levels were measured in both groups.And the sensitivity,specificity and Yodenindex of progesterone and β-HCG alone and in combination were respectively evaluated. Results Serum progesterone and β-HCG levels of pregnant women in the threatened abortion group were significantly lower than those of normal pregnant women,and the difference was statistically significant(P < 0.05).Serum progesterone and β-HCG levels in pregnant women with a successful fetus care were significantly higher than those with failed fetus care,and the difference was statistically significant(P < 0.05).The sensitivity,specificity and accuracy of progesterone combined with β-HCG in detection of threatened abortion were significantly higher than those of progesterone and β-HCG alone,and the difference was statistically significant(P < 0.05).The sensitivity,specificity and accuracy of progesterone alone in detecting threatened abortion were not statistically significantly different from those of β-HCG alone(P > 0.05).The Yoden index for progesterone alone was 0.47 and the Yoden index for β-HCG alone was 0.34.The Yoden index of combined detection was 0.86.The Yoden index of the combined detection was greater than that of the progesterone test,followed by that of the β-HCG test. Conclusion The combined detection of serum progesterone and β-HCG has higher sensitivity,specificity and accuracy in the diagnosis of pregnant women with threatened abortion,which is worthy of promotion and application.
引文
[1]贾亚楠,白华,李明静,等.血清β-人绒毛膜促性激素与孕酮动态监测对早孕期先兆流产的预测价值[J].药物评价研究,2015,38(4):402-404.
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[12]郑晓霞,舒景,康永茂.阴道超声结合CA_(125)、P、E_2、β-HCG检测对先兆流产的临床意义[J].长春中医药大学学报,2016,32(2):399-400.
[13]巩敏红,周红,周凤慧,等.雌二醇、孕酮及β-人绒毛膜促性腺激素水平变化对早期先兆性流产的预测价值分析[J].中国性科学,2016,25(9):98-101.
[14]张文霞,刘兆玮,牛立松.孕早期血清学指标与不良妊娠关系的临床研究[J].检验医学与临床,2017(A2):263-264.
[15]王娟.血清孕酮、β-hCG联合检测在早期先兆流产临床诊断中的价值[J].中国妇幼保健,2017,32(16):3885-3886.
[2]孙晶.血清孕酮、β-HCG联合检测在早期先兆流产中的诊断价值[J].中国生化药物杂志,2015,35(4):94-96.
[3]白莉莉.血清孕酮、β-HCG联合检测在早期先兆流产中的临床诊断价值[J].中国医学工程,2017,25(5):96-98.
[4]梅梅,张元珍.盐酸利托君对先兆早产患者外周血CRH、一氧化氮、前列腺素E2及IL-10水平的影响[J].中国医药导刊,2016,18(1):67-68.
[5]刘晓静.β-hCG和孕酮在早孕、早期输卵管妊娠和早期先兆流产诊断中的临床意义[J].中国妇幼保健,2015,30(8):1219-1221.
[6]何永娜.探讨血清孕酮与β-HCG联合检测在早期先兆流产治疗中的临床价值[J].中国卫生标准管理,2016,7(6):154-155.
[7]张晓东,杨超,刘薇拉,等.联合检测血清AFU、β-HCG和孕酮在先兆流产中的诊断价值[J].检验医学与临床,2017,14(10):1487-1489.
[8]蒋辉.血清人绒毛膜促性腺激素、糖类抗原125和孕酮联合检测对先兆流产结局的预测价值[J].中国妇幼保健,2017,32(19):4777-4779.
[9]许生花,杨静秀,陈霞,等.血清孕酮、CA125、hCG表达水平预测先兆流产的价值[J].中国妇幼保健,2017,32(16):3882-3884.
[10]聂磊.探讨孕早期血清雌二醇、孕酮及人绒毛促性腺激素水平预测在先兆流产诊断中的应用价值[J].中国妇幼保健,2017,32(1):110-112.
[11]朱代玉,李丽.保胎灵胶囊联合间苯三酚治疗先兆早产的临床研究[J].现代药物与临床,2018,33(1):93-96.
[12]郑晓霞,舒景,康永茂.阴道超声结合CA_(125)、P、E_2、β-HCG检测对先兆流产的临床意义[J].长春中医药大学学报,2016,32(2):399-400.
[13]巩敏红,周红,周凤慧,等.雌二醇、孕酮及β-人绒毛膜促性腺激素水平变化对早期先兆性流产的预测价值分析[J].中国性科学,2016,25(9):98-101.
[14]张文霞,刘兆玮,牛立松.孕早期血清学指标与不良妊娠关系的临床研究[J].检验医学与临床,2017(A2):263-264.
[15]王娟.血清孕酮、β-hCG联合检测在早期先兆流产临床诊断中的价值[J].中国妇幼保健,2017,32(16):3885-3886.