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在高危妊娠中,雌三醇(E_3)测定用于监护胎儿是否有临床价值,尚有争论。本文拟指明在那几种临床情况和那些方法条件下,作E_3测定能对高危胎儿起可靠的监护作用。现在常用的E_3测定法有下列4种:(1)尿E_3排泄量,足月时达45mg/24小时;(2)尿E_3肌酐比值;(3)血浆总E_3测定,足月时达200～300ng/ml;(4)血浆游离E_3测定,足月时为18ng/ml。为了选择最适合的E_3测定法和正确判断其结果,必须: 1.对E_3的生物合成,代谢与排泄要有基本的认识。 2.对各种E_3测定法的诊断能力与限度要正确了解。 3.在高危妊娠中,应用E_3测定作监护时,要有一定的临床经验。
In high-risk pregnancy, there is still controversy about the use of estriol (E_3) in monitoring the fetus for clinical value. This article intends to indicate in those few clinical conditions and those methods, for E_3 determination of high-risk fetus can play a reliable guardianship. Now commonly used E_3 assay has the following four kinds: (1) urinary E_3 excretion, reaching 45mg / 24 hours in term; (2) urinary E_3 creatinine ratio; (3) total plasma E_3 determination of up to 200 ~ 300ng / ml; (4) plasma free E_3 determination, full-term when 18ng / ml. In order to choose the most suitable E_3 assay and correctly determine the results, we must: 1. Have a basic understanding of E_3 biosynthesis, metabolism and excretion. 2. The diagnostic capabilities and limits of various E_3 assays should be correctly understood. 3. In high-risk pregnancy, the application of E_3 determination for monitoring, there must be some clinical experience.