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目的探讨输卵管异位妊娠患者血清β-HCG水平与甲氨蝶呤单剂量重复注射疗效的关系。方法全部病例用单剂量治疗后,观察胚胎溶解吸收情况,在治疗后的第1、4、7 d检测血清β-HCG水平,并根据需要第2次和第3次重复剂量治疗,比较不同时间的β-HCG水平和β-HCG相对变化值。采用t检验、χ2检验、方差分析对不同数据统计处理。结果重复治疗的成功率是84.6%(33/39),治疗成功的患者初始β-HCG水平的均值显著低于失败者(3 915.3±3 281.3比8 379.7±2 604.4 IU/ml,P<0.05)。当β-HCG水平低于6 000 IU/ml时,治疗成功率是96%,高于6 000 IU/ml时,治疗成功率是58%,OR=18.57,95%可信区间为1.86～185.89。结论在MTX单剂量治疗后,初始β-HCG水平是唯一预测重复剂量MTX治疗成功的指标。当初始β-HCG水平在6 000 IU/ml以下时,重复注射MTX治疗异位妊娠基本是有效的。
Objective To investigate the relationship between β-HCG level and single-dose methotrexate injection in tubal ectopic pregnancy. Methods All cases were treated with a single dose, the embryo dissolution and absorption were observed, serum β-HCG levels were measured on the 1st, 4th and 7th day after treatment, and the second and third repeated doses were compared according to the different time Β-HCG levels and relative changes in β-HCG. Using t test, χ2 test, analysis of variance on different data statistics. Results The success rate of repeat treatment was 84.6% (33/39). The mean initial β-HCG level in patients with successful treatment was significantly lower than that of losers (3 915.3 ± 3 281.3 vs 8 379.7 ± 2 604.4 IU / ml, P 0.05 ). The treatment success rate was 96% for beta-HCG levels below 6,000 IU / ml, 58% for those above 6,000 IU / ml, OR = 18.57, 95% confidence interval 1.86 to 185.89 . Conclusions The initial level of β-HCG is the only predictor of the success of repeated doses of MTX following single-dose MTX. Repeated injections of MTX for ectopic pregnancy were essentially effective when initial beta-HCG levels were below 6,000 IU / ml.