超声检查联合人绒毛膜促性腺激素检测对未知部位妊娠结局的预测

摘要

Objective To explore the predictive value of ultrasonography combined withβ-Human chorionic gonado-tropin (β-hCG) detection for pregnancy outcome of unknown locations (PUL). Methods Clinical data of 120 pregnant women with PUL was retrospectively analyzed. The pregnant women were divided into normal intrauterine pregnancy group (normal group, n=34), intrauterine pregnancy abortion group (abortion group, n=23) and ectopic pregnancy group (n=63) according to the final outcome. The endometrial thickness, signal miss rate of luteal blood flow, levels of the ultrasound serum β-hCG, progesterone ( P) and ratio of β-hCG growth rate over 60% in the three groups were analyzed. Results The differences in incidence rates of abdominal pain and vagina bleeding, endometrial thickness, signal miss rate of luteal blood flow, levels of serum β-hCG, P and ratio of β-hCG growth rate over 60% in the three groups were statistically significant (P<0. 05). In normal group, the values of incidence rates of abdominal pain and vagina bleeding and signal miss rate of lu-teal blood flow were significantly lower, while the values of endometrial thickness, levels of serum β-hCG, P and ratio of β-hCG growth rate over 60% were significantly higher than those in abortion and ectopic pregnancy groups (P<0. 05). The val-ues of incidence rates of abdominal pain and vagina bleeding, endometrial thickness, signal miss rate of luteal blood flow, lev-els of serum β-hCG, P and ratio ofβ-hCG growth rate over 60% in abortion group were significantly lower than those in ectop-ic pregnancy group ( P<0. 05 ) . Conclusion Sonographic detection of endometrial thickness and luteal blood flow signal combined with serological detection of β-hCG level especially β-hCG growth rate may predict pregnancy outcome of pregnant women with PUL.%目的：探讨超声检查联合β-人绒毛膜促性腺激素（β-Human chorionic gonadotropin,β-hCG)检测对未知部位妊娠（ pregnancy of unknown location, PUL)结局的预测价值。方法回顾性分析我院诊治的120例PUL孕妇的临床资料（血清检测和超声检查资料完整),按照最终妊娠结局分为宫内妊娠正常组34例、宫内妊娠流产组23例和异位妊娠组63例。分析比较3组超声检查子宫内膜厚度、黄体血流信号缺失率及血清β-hCG水平、孕酮（ progesterone, P)水平、β-hCG增长率>60%比例。结果3组腹痛、阴道流血发生率,超声检查子宫内膜厚度、黄体血流信号缺失率以及血清β-hCG水平、P水平、β-hCG增长率>60%比例比较差异均具有统计学意义（ P<0．05)。宫内妊娠正常组腹痛、阴道流血发生率及超声检查黄体血流信号缺失率显著低于宫内妊娠流产组和异位妊娠组,超声检查子宫内膜厚度及血清β-hCG水平、P水平、β-hCG增长率>60%比例显著高于宫内妊娠流产组和异位妊娠组,差异均具有统计学意义（P<0．05)。宫内妊娠流产组阴道流血、腹痛发生率,超声检查黄体血流信号缺失率以及血清β-hCG水平、P水平、β-hCG增长率>60%比例均显著低于异位妊娠组,差异亦均具有统计学意义（ P<0．05)。结论超声检查测量子宫内膜厚度、黄体血流信号联合血清学检测β-hCG水平特别是β-hCG增长率可以预测PUL孕妇的妊娠结局。