黄体酮治疗早期先兆流产的临床效果研究

摘要

目的：探讨补充黄体酮对血清孕酮和β-hCG水平不同的早期先兆流产患者妊娠结局影响。方法：选取2015年2月-2016年1月本院收治的有1次以上自然流产史或先兆流产症状的妊娠患者278例作为研究对象，根据首次就诊孕酮水平不同将其分为四组，其中第Ⅳ组（孕酮≥80 nmol/L）作为对照，其他三组均给予补充黄体酮治疗。采用放射免疫分析法进行血β-hCG检测，采用电化学发光法技术进行孕酮检测。结果：治疗前各组间β-hCG和孕酮比较差异均有统计学意义（P<0.01）；治疗后第Ⅱ组和第Ⅲ组无胚停患者血清β-hCG和孕酮含量均明显提高；第Ⅰ组、第Ⅱ组和第Ⅳ组孕妇流产率和足月分娩率比较差异均有统计学意义（P<0.05），但第Ⅲ组和第Ⅳ组比较差异无统计学意义（P>0.05）。结论：联合监测妊娠早期血β-hCG和孕酮水平可增强预测孕早期先兆流产的准确性，给予补充黄体酮有效提高了保胎治疗的成功率，是一种值得临床积极推广的诊治方法。%Objective:To investigate the effect of pregnancy outcome about supplementation progesterone in patients with different serum progesterone and β-hCG levels for early threatened abortion.Method:From February 2015 to January 2016,278 cases of one natural abortion at least or early threatened abortions pregnant women in our hospital were selected as the research objects,they were divided into four groups according to the different progesterone levels for the first time,Ⅳ group(progesterone≥80 nmol/L) as control group,the other three groups were given supplemental progesterone treatment.Blood β-hCG were detected by radioimmunoassay method,progesterone were detected by electrochemical luminescence method. Result:Before treatment,there were significant differences among all groups in comparison of β-hCG and progesterone(P<0.05).The levels of serum β-hCG and progesterone were significantly increased after treatment in Ⅱ group and Ⅲ group .There were significant differences in abortion rate and term birth rate between I group,Ⅱgroup and Ⅳ group(P<0.05),but there was no significant difference between Ⅲ group and Ⅳ group(P>0.05). Conclusion:Combined monitoring the levels of β-hCG and progesterone can increase the predictive accuracy of early threatened abortion, supplementary progesterone can effectively improve the success of fetus protection,is worthy of clinical popularization diagnostic and therapeutic method.