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目的:探讨血清β-人绒毛膜促性腺激素(β-hCG)、孕酮水平及子宫内膜厚度检测对早期不明位置妊娠(PUL)者异位妊娠的诊断价值。方法:选取65例早期PUL者为研究对象,根据确诊结果分为正常妊娠组20例、异位妊娠组21例、自然流产组24例。比较3组研究对象血清β-hCG、孕酮水平及彩色多普勒超声下子宫内膜厚度的差异,分析影响早期PUL者异位妊娠发生率的因素。结果:异位妊娠组β-hCG和孕酮水平低于自然流产组和正常妊娠组,子宫内膜厚度也较另外两组薄;联合β-hCG、孕酮水平和子宫内膜厚度共同检测的准确性远高于单独1项或某2项联合检测的准确性;异位妊娠史、β-hCG水平、孕酮水平、子宫内膜厚度均为异位妊娠的危险因素,且后三者的OR值较高。结论:血清β-hCG、孕酮水平及子宫内膜厚度与早期PUL者异位妊娠发生密切相关,提示临床诊疗过程中可通过检测早期PUL者血清β-hCG、孕酮水平和子宫内膜厚度的情况来实现异位妊娠的及早诊断。
Objective: To investigate the diagnostic value of serum β-human chorionic gonadotropin (β-hCG), progesterone and endometrial thickness in the diagnosis of ectopic pregnancy in patients with unknown location pregnancy (PUL) in early stage. Methods: Sixty-five patients with early PUL were enrolled in this study. According to the diagnosed results, they were divided into normal pregnancy group (n = 20), ectopic pregnancy group (n = 21) and spontaneous abortion group (n = 24). The differences of serum β-hCG, progesterone levels and endometrial thickness under color Doppler were compared between the three groups, and the factors influencing the incidence of ectopic pregnancy in early PUL were analyzed. Results: The levels of β-hCG and progesterone in ectopic pregnancy group were lower than those in spontaneous abortion group and normal pregnancy group, and the thickness of endometrium was also thinner than that in the other two groups. Combined detection of β-hCG, progesterone level and endometrial thickness Accuracy is much higher than the accuracy of single or a combination of two tests; ectopic pregnancy, β-hCG levels, progesterone levels, endometrial thickness are risk factors for ectopic pregnancy, and the latter three OR value is higher. Conclusion: Serum β-hCG, progesterone levels and endometrial thickness are closely related with early PUL ectopic pregnancy, suggesting that during the clinical diagnosis and treatment can be detected by early PUL serum β-hCG, progesterone levels and endometrial thickness The situation to achieve early diagnosis of ectopic pregnancy.