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目的探讨妊娠中期血、尿人绒毛膜促性腺激素(β-HCG)水平与不良妊娠结局(妊娠高血压疾病、早产、胎膜早破)的关系。方法留取709例妊娠中期孕妇的尿样测定β-HCG标准浓度,同时抽取血清测定β-HCG值,随访病史资料至分娩。观察血、尿β-HCG水平与不良妊娠结局的关系。结果709例孕妇中,正常妊娠504名,发生妊娠高血压疾病42例,胎膜早破94例,早产69例。合并妊娠高血压疾病、胎膜早破和早产孕妇的血β-HCG值分别为(2.63±0.42)、(1.90±0.56)和(1.69±0.32)nmol/L,尿β-HCG标准浓度分别为(304.6±54.2)、(256.3±61.7)和(273.5±50.4)ng/mg,均明显高于正常孕妇的(0.88±0.32)nmol/L及(146.3±47.8)ng/mg(P值分别<0.05、0.01)。当孕妇血β-HCG>2倍中位数时,其妊娠高血压疾病、胎膜早破、早产的发生率分别为4.5%、11.2%和5.7%;尿β-HCG>2倍中位数时,分别为5.1%、8.9%和5.4%,均明显高于β-HCG≤2倍中位数孕妇(P值分别<0.05、0.01)。结论妊娠中期血、尿β-HCG水平异常升高是胎盘功能障碍的早期信号,也是发生各种不良妊娠结局的危险信号。测定尿β-HCG较抽取血清更具优越性。
Objective To investigate the relationship between the level of β-HCG in blood and urine in the second trimester of pregnancy and the outcome of adverse pregnancy (pregnancy-induced hypertension, premature labor and premature rupture of membranes). Methods The urine samples of 709 pregnant women during pregnancy were collected to determine the concentration of β-HCG. At the same time, serum β-HCG levels were determined, and the medical history was followed up until delivery. Observe the blood and urine β-HCG levels and adverse pregnancy outcomes. Results Among 709 pregnant women, there were 504 normal pregnancies, 42 cases of pregnancy-induced hypertension, 94 cases of premature rupture of membranes, and 69 cases of premature labor. The blood β-HCG values of pregnant women with combined pregnancy-induced hypertension, premature rupture of membranes and premature labor were (2.63 ± 0.42), (1.90 ± 0.56) and (1.69 ± 0.32) nmol / L, (304.6 ± 54.2), (256.3 ± 61.7) and (273.5 ± 50.4) ng / mg were significantly higher than those of normal pregnant women (0.88 ± 0.32 nmol / L and 146.3 ± 47.8 ng / mg, respectively 0.05, 0.01). The median prevalence of gestational hypertension, premature rupture of membranes and premature labor were 4.5%, 11.2% and 5.7%, respectively, and the median urinary β-HCG> 2-fold Were 5.1%, 8.9% and 5.4% respectively, which were significantly higher than those with β-HCG≤2-fold median (P <0.05, 0.01 respectively). Conclusion The abnormal increase of β-HCG level in blood and urine during the second trimester of pregnancy is an early signal of placental dysfunction and also a danger signal of various adverse pregnancy outcomes. Determination of urine β-HCG serum extracted more advantages.