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目的探讨血清人绒毛膜促性腺激素(β-h CG)水平在甲氨蝶呤(MTX)治疗异位妊娠(EP)疗效评价中的价值。方法选取2014年1月-2016年1月在该院行MTX治疗的EP患者65例为研究对象,其中51例患者治疗成功为治疗有效组,14例治疗无效为治疗无效组。比较两组血清β-h CG含量的差异,分析血清β-h CG水平以及血清β-h CG平均下降幅度与患者疗效的关系,对血清β-h CG含量预测患者疗效进行ROC曲线分析。结果治疗有效组患者治疗后1 d和治疗后7 d的血清β-h CG含量均低于治疗无效组,差异有统计学意义(P<0.05)。不同血清β-h CG水平分层(<1 000 m IU/ml,1 000~2 000 m IU/ml,>2 000 m IU/ml)患者的治疗有效率比较,差异有统计学意义(P<0.05)。不同血清β-h CG平均下降幅度(<5%,5%~10%,>10%)患者的治疗有效率比较,差异有统计学意义(P<0.05)。治疗后1 d血清β-h CG含量预测患者疗效的灵敏度和特异度分别为78.57%和82.35%,约登指数为0.609,ROC曲线下面积为85.71%;治疗后7 d血清β-h CG含量预测患者疗效的灵敏度和特异度分别为92.86%和66.67%,约登指数为0.595,ROC曲线下面积为86.41%。结论 EP患者接受MTX治疗后有效的患者血清β-h CG含量明显降低,其可作为预测患者预后的重要监测指标。
Objective To investigate the value of serum human chorionic gonadotropin (β-h CG) in evaluating the efficacy of methotrexate (MTX) in the treatment of ectopic pregnancy (EP). Methods From January 2014 to January 2016, 65 patients with EP in our hospital were enrolled in this study. Totally 51 patients were treated successfully and 14 were ineffective. The differences of serum β-h CG content between the two groups were analyzed. The relationship between serum β-h CG level and the mean decline of serum β-h CG and the curative effect of the patients were analyzed. The ROC curve analysis was performed to evaluate the effect of serum β-h CG content in the patients. Results The serum levels of β-h CG in patients in the treatment-effective group at 1 d after treatment and at 7 d after treatment were lower than those in the treatment-ineffective group (P <0.05). The treatment efficiency of patients with different serum levels of β-h CG (<1 000 m IU / ml, 1 000-2 000 m IU / ml,> 2 000 m IU / ml) was statistically significant <0.05). The treatment efficiency of patients with different mean β-h CG levels (<5%, 5% -10%,> 10%) was statistically significant (P <0.05). The sensitivity and specificity of predicting the therapeutic effect of β-h CG on the first day after treatment were 78.57% and 82.35% respectively, the Youden index was 0.609, and the area under the ROC curve was 85.71%. The serum β-h CG content The sensitivity and specificity of predicting the efficacy of the patients were 92.86% and 66.67% respectively, the Youden index was 0.595, and the area under the ROC curve was 86.41%. Conclusions Serum β-h CG levels in EP patients who are effective after MTX treatment are significantly lower, which may be used as an important monitoring index to predict the prognosis of patients.