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目的:探讨孕早期孕酮(P)及人绒毛膜促性腺激(β-HCG)的测定在胚胎预后与产后出血预测的作用。方法:回顾分析中山市陈星海医院2013年9月至2016年8月妊娠7~11周均表现有停经、阴道少量出血或下腹隐痛的孕妇182例,采用放射免疫法对孕妇的P与β-HCG水平进行检测,根据P与β-HCG水平的不同分为3组,P>25 ng/m L且β-HCG>225000 m IU/m L为A组(n=79);P<25 ng/m L、β-HCG 5~225000 m IU/m L为B组(n=54);P<25 ng/m L、β-HCG<5 m IU/m L为C组(n=49),所有孕妇均视情况给予黄体酮治疗。分别比较3组孕妇的胚胎预后情况,并比较48 h后3组孕妇β-HCG倍增的时间,并比较3组孕妇产后出血量及产后出血率。结果:A组胚胎存活率与B组相比,差异无统计学意义(P>0.05),但与C组胚胎存活率相比明显升高,差异具有统计学意义(P<0.05);48 h后A组孕妇β-HCG倍增的时间较B组及C组均缩短,差异具有统计学意义(P<0.05);A组产后出血量较B组及C组均降低,差异具有统计学意义(P<0.05);且A组产后出血率与B组、C组相比均减少,差异具有统计学意义(P<0.05)。结论:孕早期孕酮及β-HCG的测定可以对胚胎预后进行判断并为治疗提供指导,孕酮及β-HCG水平可以有效减少产后出血量,预防产后出血,对孕早期的诊断具有一定价值。
Objective: To investigate the effect of progesterone (P) and human chorionic gonadotropin (β-HCG) in early pregnancy on the prediction of embryo prognosis and postpartum hemorrhage. Methods: A retrospective analysis of Zhongshan City, Chen Xinghai Hospital, September 2013 to August 2016, 7 to 11 weeks of gestation, there were 182 pregnant women who showed menopause, vaginal bleeding or abdominal pain, using radioimmunoassay for pregnant women, P and β- HCG levels were measured and divided into three groups according to the levels of P and β-HCG: P> 25 ng / m L and β-HCG> 225000 m IU / m L for group A (n = 79) (n = 54), P <25 ng / m L, and β-HCG <5 m IU / m L for group C (n = 49) All pregnant women were given progesterone treatment as appropriate. The prognosis of embryos in three groups of pregnant women were compared, and the doubling time of β-HCG in pregnant women after 48 hours was compared. The postpartum hemorrhage and postpartum hemorrhage were compared among the three groups. Results: There was no significant difference in survival rate between group A and group B (P> 0.05), but the survival rate of group A was significantly higher than that of group C (P <0.05) The time of β-HCG doubling in group A was shorter than that in group B and C (P <0.05). The amount of postpartum hemorrhage in group A was lower than that in group B and C (P <0.05), and the difference was statistically significant P <0.05). The rate of postpartum hemorrhage in group A was lower than that in group B and C (P <0.05). Conclusion: The determination of progesterone and β-HCG in early pregnancy can determine the prognosis of embryos and provide guidance for the treatment. Progesterone and β-HCG levels can effectively reduce the amount of postpartum hemorrhage and prevent postpartum hemorrhage, which has some value in the diagnosis of early pregnancy .