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目的 探讨孕中期血绒毛膜促性腺激素 (h CG)水平异常改变与先兆子、胎膜早破及早产的关系。 方法 采用放射免疫技术测定 2 0 0例孕 15～ 2 2周妇女血清 h CG水平 ,动态观察其妊娠结局 ,分析其血 h CG水平与妊娠结局的关系。 结果 各孕周血 h CG水平中位数 (M)差异无显著性 (P>0 .0 5 ) ;发展为先兆子、胎膜早破及早产者血 h CG水平显著高于正常妊娠结局者 ,孕中期血h CG水平≥ 2 M者先兆子、胎膜早破及早产的发生率分别为 30 .9% (2 5 / 81)、35 .8% (2 9/ 81)和14.8% (12 / 81) ,显著高于血 h CG水平 <2 M者 (8.4%、6 .7%、7.6 % ,P<0 .0 1) ;以总体孕中期血h CG的中位数的 2倍为临界值 ,预测先兆子、胎膜早破及早产的特异性、灵敏性、阳性预测值及阴性预测分别为 89.4% ,6 8.7% ,40 .5 % ,和 92 .7% ;90 .1% ,73.6 % ,33.3% ,和 95 .7% ;85 .6 % ,5 0 % ,14.2 % ,和 94.9%。 结论 孕中期血 h CG升高是先兆子 ,胎膜早破及早产的危险信号 ,可作为预测不良妊娠结局的指标
Objective To investigate the relationship between the second trimester interheterochymic hCG level and preeclampsia, premature rupture of membranes and premature labor. Methods Radioimmunoassay was used to determine hCG levels in 210 women with gestational age from 15 to 22 weeks. The pregnancy outcome was dynamically observed. The relationship between hCG levels and pregnancy outcomes was analyzed. Results There was no significant difference in median h CG levels (M> 0.05) between pre-term pregnancies and pre-term premature rupture of membranes and in preterm birth The prevalences of preeclampsia, premature rupture of membranes and premature labor in the second trimester of pregnancy were 38.9% (25/81), 35.8% (29/81) and 14.8%, respectively % (12/81), which were significantly higher than those with blood CG levels <2 M (8.4%, 6.7%, 7.6%, P <0.01) Specificity, sensitivity, positive predictive value and negative predictive value were 89.4%, 67.7%, 40.5%, and 92.7% respectively for predicting preeclampsia, premature rupture of membranes and premature labor. 90.1%, 73.6%, 33.3%, and 95.7%; 85.6%, 50%, 14.2%, and 94.9%. CONCLUSION: The elevated h CGI during the second trimester of pregnancy is a risk signal for preeclampsia, premature rupture of membranes and premature labor, which may be used as an index to predict adverse pregnancy outcomes