人绒毛膜促性腺激素假性升高导致不必要的治疗。

Falsely elevated human chorionic gonadotropin leading to unnecessary therapy.

作者信息

Olsen T G, Hubert P R, Nycum L R

机构信息

David Grant Medical Center, Travis Air Force Base, California, USA.

出版信息

Obstet Gynecol. 2001 Nov;98(5 Pt 1):843-5. doi: 10.1016/s0029-7844(01)01585-x.

DOI:10.1016/s0029-7844(01)01585-x

PMID:11704179

Abstract

BACKGROUND

Analysis of serum beta-hCG aids diagnosis and treatment of intrauterine pregnancies, ectopic gestations, and gestational trophoblastic neoplasia. beta-hCG concentrations are specific for trophoblastic tissue, thus are rarely questioned.

CASES

An 18-year-old nullipara had bleeding and a positive beta-hCG. Ultrasound identified no pregnancy. She passed tissue and stopped bleeding. Serum beta-hCG remained elevated despite uterine curettage and three courses of methotrexate. Results of urine beta-hCG were negative, as was reference laboratory serum assay. A 31-year-old nullipara had a spontaneous abortion, but serum beta-hCG remained elevated. Uterine curettage found secretory endometrium, yet elevated serum beta-hCG persisted. Urine beta-hCG was negative, as was reference laboratory serum assay.

CONCLUSION

Patients with histories incongruent with serum beta-hCG findings should have urine beta-hCG analysis.

摘要

背景

血清β-人绒毛膜促性腺激素（β-hCG）分析有助于诊断和治疗宫内妊娠、异位妊娠及妊娠滋养细胞肿瘤。β-hCG浓度对滋养层组织具有特异性，因此很少受到质疑。

病例

一名18岁未生育女性出现阴道出血且β-hCG呈阳性。超声检查未发现妊娠迹象。她排出组织物后出血停止。尽管进行了刮宫术及三个疗程的甲氨蝶呤治疗，但血清β-hCG仍持续升高。尿β-hCG结果为阴性，参考实验室血清检测结果同样为阴性。一名31岁未生育女性发生自然流产，但血清β-hCG仍持续升高。刮宫术发现为分泌期子宫内膜，但血清β-hCG升高仍持续存在。尿β-hCG为阴性，参考实验室血清检测结果亦为阴性。