雌二醇判断早期先兆流产预后的价值

2020年6月第27卷第6期雌二醇、孕酮及β-人绒毛膜促性腺激素水平在预测早期先兆流产中的价值分析丘佳兰,何增辉,钟灵霞(广东省蕉岭县人民医院检验科,广东梅州514100)【摘要】目的探讨雌二醇(E2)、孕酮(P)以及β-人绒毛膜促性腺激素(β-HCG)水平在预测早期先兆流产中的价值。

方法96例早期妊娠孕妇根据妊娠结局分成两组,46例未发生先兆流产者设为研究组,50例发生早期先兆流产者设为对照组。

比较两组不同孕周的血清P、β-HCG、E2水平。

结果研究组孕3周、孕5周、孕7周、孕9周的血清P水平、β-HCG水平均显著高于对照组(P<0.05)。

两组孕3周的血清E2水平无显著差异(P>0.05),研究组孕5周、孕7周、孕9周的血清E2水平均显著高于对照组(P<0.05)。

结论联合检测血清P、β-HCG及E2对于预测早期先兆流产的发生有一定指导意义。

【关键词】早期先兆流产;雌二醇(E2);孕酮(P);β-人绒毛膜促性腺激素(β-HCG)中图分类号:R714.21文献标识码:A doi:10.3969/j.issn.1674-4659.2020.06.0735Analysis on the Value of Estradiol,Progesterone andβ-Human Chorionic Gonadotropin Levels in Predicting Early Threat⁃ened Abortion//QIU Jialan,HE Zenghui,ZHONG Lingxia(Clinical Laboratory,Jiaoling County People's Hospital,Meizhou514100,China)[Abstract]Objective To explore the value of estradiol(E2),progesterone(P)andβ-human chorionic gonadotropin(β-HCG)levels in predicting early threatened abortion.Methods96pregnant women with early pregnancy were divided into two groups according to the outcome of pregnancy.46cases without threatened abortion were set as the study group and50cases with early threatened abortion were set as the control group.Serum P,β-HCG and E2levels at different gestational weeks were compared between the two groups.Results The levels of serum P andβ-HCG at3,5,7and9weeks of gestation in the study group were significantly higher than those in the control group (P<0.05).No significant difference was found between the two groups in the serum E2level at3week of gestation(P>0.05);The serum E2 level at5,7and9weeks of gestation in the study group were significantly higher than those in the control group(P<0.05).Conclusions The combined detection of serum P,β-HCG and E2has certain guiding significance in predicting the incidence of early threatened abortion.[Key words]Early threatened abortion;Estradiol(E2);Progesterone(P);β-human chorionic gonadotropin(β-HCG)早期先兆流产是妊娠期常见的一种病理情况,多发于孕8周前。

流产与雌二醇的相关性分析摘要目的研究流产与雌二醇的相关性。

方法46例先兆流产患者，根据患者具体病情和治疗状况将其分为继续妊娠组和难免流产组，各23例。

同时选取同期23例正常早期妊娠孕妇为对照组，分析三组雌二醇水平。

结果相同孕周时，继续妊娠组和对照组雌二醇水平显著高于难免流产组，差异具有统计学意义（P＜0.05）；继续妊娠组和对照组雌二醇水平同孕周呈正相关。

结论雌二醇水平在一定程度上可预测先兆流产，为临床治疗提供科学依据，改善患者预后。

关键词流产；雌二醇；相关性在妊娠早期，早孕先兆流产为一种常见并发症，可通过B超检查发现。

临床上，在鉴别正常妊娠、难免流产和先兆流产时较为困难，具有较大的不确定性，需多次抽取患者血液进行化验，该种措施在一定程度上增加患者痛苦和经济负担，同时，可能延误最佳治疗时间。

针对该种现象的出现，相关医护人员对流产与雌二醇之间的关系进行研究，便于提高先兆流产诊断准确率，为临床治疗提供科学依据，改善患者和胎儿预后[1]。

现对流产与雌二醇的相关性展开研究分析如下。

1 资料与方法1. 1 一般资料选取本院在2013年7月～2015年6月收治的46例先兆流产患者和23例正常早期妊娠孕妇，均通过B超诊断为宫内单胎妊娠，停经时间为6～9周，将通过辅助生育技术妊娠和各种妊娠并发症患者排除在外。

根据患者具体病情和治疗状况将先兆流产患者分为继续妊娠组和难免流产组，各23例。

正常早期妊娠孕妇23例为对照组，其中年龄最大34岁，最小23岁，平均年龄（28.6±4.1）岁；继续妊娠组年龄最大35岁，最小22岁，平均年龄（29.1±3.8）岁；难免流产组年龄最大33岁，最小24岁，平均年龄（27.9±3.9）岁。

三组孕妇年龄和停经时间等一般资料相比差异无统计学意义（P>0.05），具有可比性。

1. 2 先兆流产诊断标准[2] 全部患者均通过B超确诊为宫内妊娠，先兆流产是指患者停经后，阴道出现少量流血现象，并且为血性白带或是暗红色，没有妊娠物排出，且患者没有下腹隐痛现象。

孕早期血清雌二醇水平对先兆流产预后的预测研究及临床意义张 健 赵广成 张洪星 马传燕 张 鹏山东省滨州市中心医院产科，山东滨州 251700[摘要]目的 探究孕早期血清雌二醇（E2）水平对先兆流产预后的预测研究及临床意义。

方法 选取2016年5月～2018年5月接受先兆流产患者210例作为研究组，所有患者进行保胎治疗，根据保胎结果将研究组分为成功组（136例）和失败组（74例）。

同时选取同期在我院进行常规检查的正常妊娠孕妇80例作为对照组。

治疗前比较研究组和对照组的血清E2水平，并比较保胎成功组和失败组治疗前和治疗7d后以及28d后的血清E2水平。

分析血清E2水平对保胎成功的诊断效能。

比较保胎成功组和对照组的妊娠结局。

结果入院时研究组血清E2水平显著低于对照组，差异有统计学意义（P＜0.05）。

治疗前两组患者的血清E2水平比较，差异无统计学意义（P＞0.05），治疗后两组患者的血清E2水平均显著升高，差异有统计学意义（P＜0.05），治疗7d和28d后保胎成功组的血清E2水平均显著高于保胎失败组，差异有统计学意义（P＜0.05）。

保胎成功组与对照组妊娠结局比较，差异无统计学意义（P＞0.05）。

结论先兆流产患者的血清E2水平显著低于正常妊娠孕妇，并且保胎成功患者的血清E2水平显著高于保胎失败患者。

[关键词]孕早期；雌二醇；先兆流产；预后[中图分类号]R714.2+1 [文献标识码]A [文章编号]2095-0616（2020）22-88-04 Predictive study and clinical significance of serum estradiol level in early pregnancy for the prognosis of threatened abortionZHANG Jian ZHAO Guangcheng ZHANG Hongxing MA Chuanyan ZHANG Peng Department of Obstetrics, Binzhou Center Hospital, Shandong, Binzhou 251700, China[Abstract] Objective To explore the predictive study and clinical significance of serum estradiol (E2) level in early pregnancy for the prognosis of threatened abortion.Methods A total of 210 patients with threatened aborti on admitted from May 2016 to May 2018 were selected as the study group. All the patients in the study group were treated with method of preventing miscarriage. According to the results of preventing miscarriage, the study group was divided into the success group (n=136) and the failure group (n=74). Meanwhile, 80 normal pregnant women whohad routine examination in our hospital were selected as the control group. Serum E2level was compared between the study group and the control group before treatment, and between the success group and the failure group in preventingmiscarriage before treatment, after 7d of treatment and 28d of treatment. The diagnostic efficacy of serum E2level for successful prevention of miscarriage was analyzed. The pregnancy outcome was compared between the success groupin preventing miscarriage and the control group.Results At admission, the serum E2level of the study group was significantly lower than that of the control group, and the difference was statistically significant (P＜0.05). Beforetreatment, there was no statistically significant difference in serum E2level between the two groups (P＞0.05), andthere was statistically significant difference in serum E2level between the two groups after treatment (P＜0.05). After7d of treatment and 28d of treatment, the serum E2levels of the success group in preventing miscarriage were both significantly higher than those of the failure group in preventing miscarriage, and the differences were statistically significant (P＜0.05). There was no statistically significant difference in pregnancy outcome between the success group inpreventing miscarriage and the control group (P＞0.05). Conclusion The serum E2level of the patients with threatenedabortion is significantly lower than that of normal pregnant women, and the serum E2level of the patients preventing miscarriage successfully is significantly higher than that of the patients who fail in preventing miscarriage.[Key words] Early pregnancy; Estradiol; Threatened abortion; Prognosis调查研究发现，随着我国妇女工作环境、生活习惯和妊娠观念的转变，先兆流产在我国的发生率有上升趋势[1]。

血清雌二醇和β-HCG检测预测早期先兆流产产妇妊娠结果的价值分析陈碧;任博文【期刊名称】《医药前沿》【年(卷),期】2024(14)12【摘要】目的:探讨血清雌二醇和β-人绒毛膜促性腺激素(β-HCG)检测预测早期先兆流产产妇妊娠结局的价值。

方法:选取2021年2月—2023年2月宁夏回族自治区中医医院检验科收治的200例早期先兆流产孕妇,根据妊娠结局分为妊娠失败组与继续妊娠组,各100例。

另选取同期常规产检的正常妊娠孕妇100名作为正常妊娠组。

检测三组孕6、7、8周的孕妇血清雌二醇和β-HCG水平以及妊娠失败组和继续妊娠组治疗后3d、1周的血清雌二醇和β-HCG水平。

以B超检查结果为金标准,比较三组血清雌二醇和β-HCG单独与联合检测的阳性情况,比较血清雌二醇和β-HCG单独与联合检测的预测价值。

结果:三组孕妇孕7、8周的血清雌二醇和β-HCG水平均高于孕6周,差异有统计学意义(P<0.05)。

孕6、7、8周,妊娠失败组、继续妊娠组的血清雌二醇和β-HCG水平低于正常妊娠组,差异有统计学意义(P<0.05)。

治疗后1周,妊娠失败组孕妇的血清雌二醇和β-HCG水平均低于治疗后3d,继续妊娠组孕妇的血清雌二醇和β-HCG水平均高于治疗后3d,差异有统计学意义(P<0.05);治疗后3d、1周,妊娠失败组孕妇的血清雌二醇和β-HCG水平均低于继续妊娠组,差异有统计学意义(P<0.05)。

三组孕妇的血清雌二醇和β-HCG联合检测的阳性率均高于单独检测,差异有统计学意义(P<0.05);妊娠失败组、继续妊娠组孕妇的血清雌二醇和β-HCG单独与联合检测的阳性率均高于正常妊娠组,妊娠失败组孕妇的血清雌二醇和β-HCG单独与联合检测的阳性率均高于继续妊娠组,差异有统计学意义(P<0.05)。

血清雌二醇和β-HCG联合检测的预测价值高于单独检测,差异有统计学意义(P<0.05)。

血清雌二醇水平对早期先兆流产预后的预测价值张雪华【期刊名称】《实用临床医药杂志》【年(卷),期】2016(020)011【总页数】3页(P198-200)【关键词】血清雌二醇;早期先兆流产;预后;预测价值【作者】张雪华【作者单位】山东省聊城市中医医院,山东聊城,252000【正文语种】中文【中图分类】R714.21早期先兆性流产一般指在孕12周之前停经后阴道内有少量出血的现象，但无妊娠物排出，这种现象属于妊娠的多发症状，具有频发的倾向性[1-2]。

研究[3]表明，对早期先兆性流产者，除了染色体异常的患者无法治疗外，其余绝大部分患者均能够通过及时、有效的治疗后继续妊娠。

雌二醇(E2)、孕酮(P)、绒毛膜促性腺激素(hCG)是保障早期妊娠持续的重要因素。

本研究探讨雌二醇对早期先兆流产的预后价值，现报告如下。

选择2013年1月—2015年1月本院收治的100例早期先兆性流产患者，多数患者符合早期的妊娠先兆性流产诊断标准[4]，所有患者在入院前都通过B超检查并确诊。

根据B超检查的妊娠结果，将100例患者随机分为妊娠成功组(n=50)和妊娠失败组(n=50)。

妊娠成功组年龄23～35岁，平均(25.23±2.18)岁；有人工流产史者7例，自然流产史9例；首次妊娠者34例。

妊娠失败组年龄22～35岁，平均(24.39±3.23)岁；有人工流产史者9例，自然流产史9例；首次妊娠者32例。

2组患者一般资料比较无显著差异(P>0.05)。

另选择正常的早孕健康妇女50例作为对照组，年龄23～36岁，平均年龄(25.9±3.2)岁，孕周<8周者13例，8～9周19例，10～12周18例。

纳入标准：参照《中医临床诊疗方案》、《中医妇科学》中的标准[5]进行诊断: ① 妊娠后阴道处有少量出血，颜色浅淡，伴随腹痛、腰痛; ② 经检查发现宫颈口未开，且子宫增大，与孕周相符合; ③ B超显示宫内妊娠。

监测血清CA125结合雌二醇判断早期先兆流产不良结局的临床观察王峰;言齐;郭伟娣【摘要】Objective To investigate the value of monitoring serum CA125 combined with estradiol in judgement of adverse outcome of early threatened abortion. Methods 120 patients with symptoms of early threatened abortion in our hospital from May 2015 to May 2016 were selected as the research object. According to the outcome of pregnancy, they were divided into continuing pregnancy group (66 cases) and failed pregnancy group (54 cases). Electrochemical immunoassay was used to detect serum CA125, E2 levels. Another 50 cases of normal pregnant women were selected as control group, for the same detection. Detection results of the indicators between the three groups of pregnant women were compared. The sensitivity, specificity and accuracy of calculation and the different indicators alone or in combination to determine the early threatened abortion adverse outcomes were calculated. Results Through monitoring of serum CA125, HCG, E2, there had the situation of pregnancy failure group > pregnancy group> normal pregnancy group on CA125. E2 , HCG level comparison showed the opposite pattern, and there were statistically significant differences in each of the two groups (P < 0.05). At the same time, CA125 and E2 combined to predict adverse outcome of threatened abortion sensitivity, specificity and accuracy were 96.30%, 98.48%, 97.50%, two indicators were significantly higher than those ofsingle detection results, with significant difference (P < 0.05). Conclusion The combined monitoring of serum CA125 and estradiol in patients with early threatened abortion can effectively predict adverse outcomes. It has great clinical value.%目的：探讨监测血清 CA125结合雌二醇判断早期先兆流产不良结局的应用价值。

血清雌二醇、β-绒毛膜促性腺激素及孕酮水平检测在早期先兆流产结局预测中的应用价值吴碧云毛文礼张美婵胡红英广东省英德市妇幼保健计划生育服务中心检验科,广东英德513000[摘要]目的探讨血清雌二醇(E2)、β-绒毛膜促性腺激素(β-HCG)及孕酮(P)水平检测在早期先兆流产结局预测中的应用价值。

方法回顾性分析2019年8月~2020年7月广东省英德市妇幼保健计划生育服务中心收治的52例早期先兆流产孕妇的临床资料,根据妊娠结局的不同将其分为继续妊娠组(36例)与妊娠失败组(16例),另选取同期在广东省英德市妇幼保健计划生育服务中心行常规产检的36例正常妊娠孕妇作为对照组,入组时采集三组5mL空腹静脉血,测定血清E2、β-HCG、P水平。

比较三组孕妇血清E2、β-HCG、P水平和三者单项、联合诊断预测早期先兆流产阳性率,分析E2、β-HCG、P单项和联合诊断预测早期先兆流产结局的价值。

结果妊娠失败组孕妇的E2、β-HCG、P水平低于继续妊娠组和对照组,继续妊娠组孕妇的E2、β-HCG、P水平低于对照组,差异有统计学意义(P<0.05)。

妊娠失败组、继续妊娠组E2、β-HCG、P单项和联合诊断阳性率高于对照组,差异有统计学意义(P<0.05);妊娠失败组E2、β-HCG、P单项和联合诊断阳性率高于继续妊娠组,差异有统计学意义(P<0.05)。

E2、β-HCG、P联合诊断预测早期先兆流产结局的敏感度(93.24%)和特异性(89.10%)高于单一诊断,差异有统计学意义(P<0.05)。

结论E2、β-HCG、P均是判断早期先兆流产和预测孕妇妊娠结局的有效指标,联合诊断能提高诊断符合率,可作为预测早期先兆流产和妊娠结局的有效指标。

[关键词]早期先兆流产;雌二醇;β-绒毛膜促性腺激素;孕酮[中图分类号]R714.21[文献标识码]A[文章编号]1674-4721(2021)2(c)-0149-04 Application value of serum estradiol,β-chorionic gonadotropin and pro⁃gesterone levels detection in predicting the outcomes of early threatened abortionWU Bi-yun MAO Wen-li ZHANG Mei-chan HU Hong-yingDepartment of Laboratory,Maternity and Child Health Family Planning Service Center in Yingde City,Guangdong Province,Yingde513000,China[Abstract]Objective To explore the application value of serum estradiol(E2),β-chorionic gonadotropin(β-HCG)and progesterone(P)levels detection in predicting the outcomes of early threatened abortion.Methods Clinical data of 52pregnant women with early threatened abortion who were admitted to Maternity and Child Health Family Planning Service Center in Yingde City,Guangdong Province from August2019to July2020was selected and divided into con⁃tinued pregnancy group(36cases)and pregnancy failure group(16cases)according to the different pregnancy out⁃comes.Another36normal pregnant women who underwent routine check-ups in Maternity and Child Health Family Planning Service Center in Yingde City,Guangdong Province during the same period were selected as the control group.During enrollment,participants in the three groups were collected5mL fasting venous blood for measuring the serum E2,β-HCG and P levels.The serum E2,β-HCG and P levels of the three groups of pregnant women were com⁃pared.The positive rate of early threatened abortion predicted by the serum E2,β-HCG and P levels alone or in com⁃bination as well as its value was compared and analyzed among the three groups.Results The levels of E2,β-HCG and P in the pregnancy failure group were lower than those in the continued pregnancy group and the control group,the levels of E2,β-HCG and P in the continued pregnancy group were lower than those in the control group,and the dif⁃ferences were statistically significant(P<0.05).The diagnostic positive rates of E2,β-HCG and P alone and in combina⁃tion in the pregnancy failure group and continued pregnancy group were higher than that of the control group,and the [基金项目]广东省清远市科技计划项目(190917084569839)149CHINA MODERN MEDICINE Vol.28No.6February2021早期先兆流产发生率占妊娠总数的10%~15%,是妊娠期常见疾病之一,其发生与母体体质虚弱、免疫功能异常、内分泌异常、外伤、全身性疾病、劳累和胚胎染色体异常等密切相关[1-3]。

雌二醇、人绒毛膜促性腺激素及糖类抗原125与先兆流产妊娠预后的关系研究目的：分析雌二醇（E2）、人绒毛膜促性腺激素（hCG）以及糖类抗原125（CA125）与先兆流产妊娠预后之间的关系。

方法：选择100例先兆流产妊娠患者进行研究，按照妊娠结局分为继续妊娠组60例和妊娠失败组40例，并选择50例健康早孕妇女作为对照组。

检测三组的E2、hCG以及CA125水平，并比较分析各监测指标的意义。

结果：继续妊娠组和对照组的E2、hCG水平显著高于妊娠失败组，差异均有统计学意义（P＜0.05）；妊娠失败组的CA125水平显著高于继续妊娠组和对照组，差异均有统计学意义（P＜0.05）。

结论：先兆流产妊娠患者的E2、hCG以及CA125水平与妊娠预后之间存在较大的关系。

联合检测各项指标，对于早期正确评估先兆流产预后具有重要的临床意义。

标签：先兆流产；妊娠预后；雌二醇；人绒毛膜促性腺激素；糖类抗原125流产是一种常见的妇产科疾病，按照时间的不同可以分为不同的类型，例如先兆流产和不全流产以及过期流产等[1-2]。

其中，先兆流产指的是妊娠时间在28周以内即出现自然终止。

如果阴道不再流血，且腹痛情况消失，经B超检查胚胎仍然存活的话，即可继续妊娠。

反之，则应当予以终止妊娠。

为了更加准确的判断先兆流产的结局，可以对患者的各项激素水平进进行检测。

本研究选取本院2010年10月-2013年10月收治的先兆流产妊娠患者100例进行研究，分析雌二醇（E2）、人绒毛膜促性腺激素（hCG）及糖类抗原125（CA125）与先兆流产妊娠预后之间的关系。

现将研究结果进行如下报告。

1 资料与方法1.1 一般资料选取2010年10月-2013年10月本院收治的先兆流产妊娠患者100例进行研究，年龄23～29岁，怀孕4～8周，经B超检查为早孕。

按照妊娠结局分为继续妊娠组60例和妊娠失败组40例，并从同期在本院接受检查的健康早孕妇女中随机选择50例作为对照组。