陈海波,王婷,杨达刚
CHEN Haibo,WANG Ting,YANG Dagang

• 1:海南医学院第二附属医院输血科

摘要(Abstract)：

目的 探讨血清孕酮、β-人绒毛膜促性腺激素（β-HCG）及尿碘水平对早期妊娠先兆流产保胎结局的预测价值。方法 将106例先兆流产孕妇根据妊娠结局分为继续妊娠组（n=79）、妊娠失败组（n=27），同期产检的100名健康孕妇作为健康对照组，先兆流产组孕妇给与常规保胎治疗4周，采集3组孕妇静脉血采用电化学发光免疫法测定血清孕酮、β-HCG水平，采用比色法检测尿碘水平，比较3组孕妇血清孕酮、β-HCG及尿碘水平；采用受试者工作特征（ROC）曲线下面积（AUC）评估血清孕酮、β-HCG及尿碘单独或三者联合检测对先兆流产孕妇妊娠结局的预测效能。结果 先兆流产组孕妇血清孕酮、β-HCG及尿碘水平低于健康对照组，妊娠失败组孕妇血清孕酮、β-HCG及尿碘水平低于继续妊娠组，差异有统计学意义有（P<0.001）;ROC分析结果显示，血清孕酮、β-HCG及尿碘3项指标联合检测的AUC=0.872，当Youden指数最大时，其灵敏度为86.1%，特异度为88.9%，均高于单一指标检测。结论 血清孕酮、β-HCG及尿碘水平对早期妊娠先兆流产孕妇保胎结局具有一定的预测价值，且3项指标联合检测的预测效能更佳。
Objective To investigate predictive value of the levels of serum progesterone, β-human chorionic gonadotropin( β-HCG) and urinary iodine on the fetus outcome of threatened abortion in early pregnancy.Methods A total of 106 pregnant women with threatened abortion were divided into continued pregnancy(n= 79) and pregnancy failure groups(n= 27) according to pregnancy outcomes. One hundred healthy pregnant women who underwent antenatal check-up during the same period were used as healthy control group. Pregnant women with threatened abortion were given routine fetus protecting treatment for 4 weeks. The venous blood of pregnant women in three groups was collected, and the serum progesterone and β-HCG levels were determined by electrochemiluminescence immunoassay. Urinary iodine level was detected by colorimetry. The levels of serum progesterone, β-HCG and urinary iodine were compared among three groups. Area under the receiver operating characteristic(ROC) curve(AUC) was used to evaluate the predictive power of serum progesterone,β-HCG, and urinary iodine alone or in combination in predicting pregnancy outcomes in women with threatened abortion.Results The levels of serum progesterone, β-HCG, and urinary iodine in women with threatened abortion were lower than those in healthy control group(P< 0. 05), and less in pregnancy failure group than those in continued pregnancy group(P< 0. 001). ROC analysis showed that theAUCof the combination of serum progesterone, β-HCG, and urine iodine was 0. 872. When the Youden index was the largest, ROC sensitivity and specificity were 86. 1% and 88. 9%, which were higher than those of a single indicator.Conclusion The levels of serum progesterone, β-HCG,and urinary iodine have a certain predictive value for the outcome of fetus protection of women with threatened abortion in early pregnancy. The prediction performance of their combination is better than a single indicator.

关键词(KeyWords)： 先兆流产;妊娠结局;孕酮;β-人绒毛膜促性腺激素;尿碘;临床意义
threatened abortion;pregnancy outcome;progesterone;β-human chorionic gonadotropin(β-HCG);urinary iodine;clinical significance

Abstract:

Keywords:

基金项目(Foundation): 海南省卫生计生行业科研项目（20A200050）

作者(Author): 陈海波,王婷,杨达刚
CHEN Haibo,WANG Ting,YANG Dagang

DOI: 10.19367/j.cnki.2096-8388.2022.06.016

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