胡诗婉,唐倩
HU Shiwan,TANG Qian

• 1:宜宾市第二人民医院妇产科
• 2:四川省人民医院妇产科

摘要(Abstract)：

目的:分析母体血清游离人绒毛膜促性激素β亚基(β-HCG)和游离雌三醇(u E3)水平对妊娠期并发症及妊娠结局的预测作用。方法:选取孕中期孕产妇364例,记录其妊娠期并发症及妊娠结局情况,分为妊娠期并发症组及无妊娠期并发症组、不良妊娠结局组及无不良妊娠结局组,比较各组孕妇孕中期血清游离β-HCG和u E3水平,制作受试者工作特征(ROC)曲线评估血清游离β-HCG、u E3水平与妊娠期并发症及不良妊娠结局的关系。结果:妊娠期并发症组81例(22. 25%),未出现妊娠期并发症组283例(77. 75%),两组孕妇的年龄、孕次、产次等一般资料比较,差异无统计学意义(P> 0. 05),妊娠期并发症组孕中期血清游离β-HCG明显高于无妊娠期并发症组(P <0. 05),u E3则低于无妊娠期并发症组(P <0. 05);不良妊娠结局组28例(7. 69%),未出现不良妊娠结局336例(92. 31%),两组孕妇年龄、孕次、产次等一般资料比较差异无统计学意义(P> 0. 05),不良妊娠结局组孕中期血清游离β-HCG明显高于无不良妊娠结局组(P <0. 05),u E3则低于无不良妊娠结局组(P <0. 05);孕中期血清游离β-HCG、u E3水平对妊娠期并发症及不良妊娠结局均具有较高预测价值(AUC=0. 714、0. 756、0. 958、0. 789,P <0. 05),其截断值分别为41. 085 k U/L、1. 155μg/L、52. 275 k U/L、1. 065μg/L。结论:孕中期血清游离β-HCG及u E3水平可用于预测妊娠期并发症及不良妊娠结局。
Objective: To analyze the predictive effects of maternal serum free human chorionic gonadotropin β subunit( β-HCG) and uncojugated estriol( uE3) levels on pregnancy complications and pregnancy outcomes. Methods: 364 pregnant and lying-in women in the second trimester of pregnancy were selected. The pregnancy complications and pregnancy outcomes were recorded and the patients were divided into pregnancy complication group,non-pregnancy complication group,adverse pregnancy outcome group and non-adverse pregnancy outcome group. The levels of serum free β-HCG and u E3 of each group in the second trimester of pregnancy were compared. Receiver operating characteristic curve( ROC curve) was made to evaluate the relationship between serum free β-HCG and uE3 levels and pregnancy complications and adverse pregnancy outcomes. Results: Among 364 pregnant and lying-in women,there were 81 cases( 22. 25%) in the gestational complications group and 283 cases( 77. 75%) in the non-gestational complications group. There was no statistically significant difference in terms of age,pregnancy and birth rate between the two groups( P > 0. 05).Serum free β-HCG in the second trimester of pregnancy in pregnancy complication group was significantly higher than that in non-pregnancy complication group( P < 0. 05) while the u E3 level was lower than that in non-pregnancy complication group( P < 0. 05). Among 364 cases of pregnant and lying-in women,there were 28 cases( 7. 69%) with adverse pregnancy outcome group,and 336 cases( 92. 31%) with non-adverse pregnancy outcome group. There was no statistically significant difference in terms of age,pregnancy,and second birth between the two groups( P > 0. 05). The serum free β-HCG in the second trimester of pregnancy in adverse pregnancy outcome group was significantly higher than that in non-adverse pregnancy outcome group( P < 0. 05) while the u E3 was lower than that in non-adverse pregnancy outcome group( P < 0. 05). In the second trimester of pregnancy,serum freeβ-HCG and uE3 had higher predictive value on pregnancy complications and adverse pregnancy outcomes( AUC = 0. 714,0. 756,0. 958,0. 789,P < 0. 05),and the cutoff values were 41. 085 k U/L,1. 155 μg/L,52. 275 k U/L and 1. 065 μg/L respectively. Conclusion: Serum free β-HCG and uE3 in the second trimester can predict pregnancy complications and adverse pregnancy outcomes,and have high clinical application value.

关键词(KeyWords)： 妊娠;妊娠并发症;妊娠结局;人绒毛膜促性激素β亚基;游离雌三醇
pregnancy;pregnancy complications;pregnancy outcome;human chorionic gonadotropin β subunit(β-HCG);uncojugated estriol(u E3)

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生和计划生育委员会科研课题(201600531)

作者(Author): 胡诗婉,唐倩
HU Shiwan,TANG Qian

DOI: 10.19367/j.cnki.2096-8388.2020.05.018

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