Buyalos R P, Glassman L M, Rifka S M, Falk R J, Macarthy P O, Tyson V J, DiMattina M
Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, D.C.
J Reprod Med. 1992 Mar;37(3):261-6.
We prospectively studied 110 asymptomatic female infertility patients with serial serum measures of beta-human chorionic gonadotropin (hCG), estradiol (E2) and progesterone (P) to determine their sensitivity, specificity, predictive value and test efficiency, alone or in combination, for the prediction of pathologic gestations prior to five weeks after ovulation. Circulating levels of serum beta-hCG, E2 and P were measured at 48- or 72-hour intervals. Seventy-four patients (67%) had viable pregnancies, for which the abnormal changes in steroid levels were defined as: a beta-hCG rise of less than 66% in 48 hours or less than 120% in 72 hours, an E2 decline of greater than 15% in 48 hours or greater than 20% in 72 hours, or a P decline of greater than 25% in 48 hours or greater than 33% in 72 hours. Thirty-six women (33%) had pathologic pregnancies, which included ectopic pregnancies (8), spontaneous or missed abortions (7), blighted ova (anembryonic gestation, 20) and hydatidiform mole (1). For the detection of pathologic pregnancies in this asymptomatic infertility population, the sensitivity of beta-hCG, E2 and P, singly or in combination, ranged from 34% to 78%, and the test efficiency ranged from 68% to 88%. Beta-hCG alone provided the highest sensitivity (78%) and test efficiency (88%). When compared to measuring serial beta-hCG alone, serum E2 or P did not enhance the test efficiency and lowered the sensitivity for the detection of pathologic pregnancies in an asymptomatic infertility population.
我们前瞻性地研究了110例无症状女性不孕症患者，通过连续测定血清β-人绒毛膜促性腺激素（hCG）、雌二醇（E2）和孕酮（P），以确定它们单独或联合使用时，对于预测排卵后五周内病理性妊娠的敏感性、特异性、预测价值和检测效率。血清β-hCG、E2和P的循环水平每隔48或72小时测量一次。74例患者（67%）有活胎妊娠，其类固醇水平的异常变化定义为：β-hCG在48小时内升高小于66%或在72小时内升高小于120%，E2在48小时内下降大于15%或在72小时内下降大于20%，或P在48小时内下降大于25%或在72小时内下降大于33%。36名女性（33%）有病理妊娠，其中包括异位妊娠（8例）、自然流产或稽留流产（7例）、枯萎卵（胚胎停育，20例）和葡萄胎（1例）。对于该无症状不孕症人群中病理妊娠的检测，β-hCG、E2和P单独或联合使用时的敏感性范围为34%至78%，检测效率范围为68%至88%。单独使用β-hCG时敏感性最高（78%），检测效率也最高（88%）。与单独测定连续β-hCG相比，血清E2或P并未提高检测效率，反而降低了无症状不孕症人群中病理妊娠检测的敏感性。
