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目的:探讨血清人绒毛膜促性腺激素(β-hCG)、孕酮(P)水平及盆腔积液程度、异位妊娠病灶大小对异位妊娠保守治疗的预测价值。方法:150例异位妊娠患者随机分为A、B、C组,每组50例,分别给予不同的保守治疗方案,A组:甲氨蝶呤多次给药,B组:甲氨蝶呤多次给药+四氢叶酸,C组:甲氨蝶呤单次给药,各组治疗前清晨空腹采集静脉血,采用化学发光法测定血清中β-hCG、P水平;阴道彩色超声检测盆腔积液、病灶情况,治疗2~3个疗程后评价治疗效果,分析各检测因素对治疗效果的影响。结果:150例患者共治愈117例(治愈组),治疗失败33例(失败组)。A、B、C组治愈率分别为78.0%、76.0%、80.0%,组间无统计学差异(P>0.05)。治愈组血清β-hCG、P水平、盆腔积液最大径线值均明显低于失败组(P<0.01)。各检测因素对治疗效果的影响如下:随着血清β-hCG水平、P水平、盆腔积液最大径线值升高,治愈率有下降趋势。结论:血清β-hCG、孕酮水平及盆腔积液、异位妊娠病灶大小是监测病情的指标,也是影响保守治疗效果的因素。
Objective: To investigate the predictive value of serum human chorionic gonadotropin (β-hCG), progesterone (P) and pelvic fluid concentration, ectopic pregnancy size of conservative treatment of ectopic pregnancy. Methods: 150 cases of ectopic pregnancy were randomly divided into A, B, C group, 50 cases in each group, were given different conservative treatment programs, A group: methotrexate multiple administration, B group: methotrexate Multiple administration of + tetrahydrofolate, C group: methotrexate single administration, fasting blood samples were collected before treatment in each group, using the chemiluminescence method to determine serum β-hCG, P levels; vaginal color ultrasound detection of pelvic Effusion, lesions, the treatment of 2 to 3 courses after the evaluation of treatment, analysis of the impact of various test factors on the treatment effect. Results: A total of 117 patients (cured group) were cured in 150 patients, and 33 patients failed in treatment (failed group). The cure rates in groups A, B and C were 78.0%, 76.0% and 80.0%, respectively, with no significant difference (P> 0.05). The levels of serum β-hCG and P and the maximum diameter of pelvic fluid in the cured group were significantly lower than those in the failed group (P <0.01). The effect of each test factor on the treatment effect is as follows: With the serum level of β-hCG, P level, the maximum diameter of pelvic fluid increased, the cure rate decreased. Conclusion: Serum β-hCG, progesterone levels and pelvic fluid effusion, ectopic pregnancy lesions size is an indicator of disease status, but also affect the conservative treatment effect factors.