目的 探讨血清雌二醇(E₂)、β-绒毛膜促性腺激素(β-HCG)以及孕酮(P)在早期先兆流产结局预测中的应用价值。方法 选取2015年2月~2017年2月本院收治的5~9 W先兆流产孕妇142例作为研究对象,根据妊娠结局分为妊娠组(早期先兆性流产继续妊娠)97例与流产组(早期先兆性流产妊娠失败)45例,另选50例在本院定期常规产检的正常妊娠孕妇作为对照组。检测所有孕妇血清E₂、β-HCG及P水平,并分析三指标单项及联合应用预测早期先兆流产妊娠结局的准确性。结果 三组孕妇血清E₂、β-HCG及P水平比较,具有统计学意义(F值依次为8.468、3.534、4.182,均P＜0.05);妊娠组与流产组孕妇血清E₂、β-HCG及P水平均显著低于对照组,均具有统计学意义(均P<0.05);流产组孕妇血清E₂(826.55±109.84 pmol/L)、β-HCG(3 785.35±1059.08 IU/L)及P(33.67±13.27 nmol/L)水平均显著低于妊娠组(2 753.61±793.24 pmol/L)、(27 232.43±2847.22 IU/L)、(86.85±19.95 nmol/L),均具有统计学意义(t值依次为9.248、21.637、3.902,均P<0.05)。对照组、妊娠组以及流产组的单项及联合检测检出率之间比较差异显著,均具有统计学意义(均P<0.05);三组血清E₂+β-HCG+P联合检测检出率4.00%(2/50)、93.81%(91/97)、95.65%(44/45)均分别显著高于血清E₂、β-HCG及P单项检测,均具有统计学意义(均P<0.05)。血清E₂+β-HCG+P联合检测敏感性(95.48%)、特异性(96.97%)以及诊断符合率(97.34%)分别显著高于单项检测,均具有统计学意义(均P<0.05)。结论 血清E₂+β-HCG+P联合检测敏感性、特异性均显著高于单项检测,具有较高的诊断符合率,可作为早期先兆流产诊断的重要指标。

Objective To explore the application value of serum estradiol (E₂),β-human chorionic gonadotropin (β-HCG) and progesterone (P) in predicting early threatened abortion outcomes. Methods A total of 142 cases of 5 to 9 weeks early threatened abortion pregnant women admitted to our hospital from February 2015 to February 2017 were selected as the research objects.According to the pregnancy outcome, 97 cases of pregnancy group (early threatened abortion continues pregnancy) and 45 cases of abortion group (early threatened abortion pregnancy failed) were divided into two groups.Another 50 cases of normal pregnant women with regular routine obstetric examination in our hospital were selected as the control group.The serum E₂, β-HCG and P levels in all pregnant women were detected, and the accuracy of single and combined use of these three indicators in predicting pregnancy outcomes of early threatened abortion was analyzed. Results The levels of serum E₂, β-HCG and P in the three groups of pregnant women were statistically significant (F values were 8.468, 3.534 and 4.182, respectively,P_all<0.05).The serum E₂, β-HCG and P levels in pregnancy group and abortion group were significantly lower than those of control group, the difference was statistically significant (P_all<0.05).The levels of serum E₂ (826.55±109.84 pmol/L), β-HCG (3 785.35±1 059.08 IU/L) and P (33.67±13.27 nmol/L) in the abortion group were significantly lower than those in the pregnancy group [(2 753.61±793.24) pmol/L, (27 232.43±2 847.22) IU/L, (86.85±19.95) nmol/L, respectively], and the difference were statistically significant (t values were 9.248, 21.637, 3.902, respectively,P_all<0.05).There were significant difference in the detection rates of single and combined tests among the control group, pregnancy group and abortion group (P_all < 0.05).The combined detection rates of E₂+β-HCG+P in serum of the three groups were 4.00% (2/50), 93.81% (91/97) and 95.65% (44/45), which were significantly higher than the single detection rates of each index, and the difference was statistically significant (P_all<0.05).The sensitivity, specificity and diagnostic coincidence rate of combined detection of serum E₂+β-HCG+P were 95.48%, 96.97% and 97.34% respectively, which were significantly higher than those of single detection, and the difference was statistically significant (P_all<0.05). Conclusion The sensitivity and specificity of serum E₂+β-HCG+P combined detection were significantly higher than that of single detection, which had a high diagnostic coincidence rate and could be used as an important indicator for diagnosis of predicting early threatened abortion.