Hirata A J, Soper D E, Bump R C, Hurt W G
Department of Obstetrics and Gynecology, Medical College of Virginia, Virginia Commonwealth University, Richmond.
South Med J. 1991 Dec;84(12):1467-9. doi: 10.1097/00007611-199112000-00014.
We evaluated the medical history, physical examination, and laboratory tests done on 245 patients with laparoscopically proven ectopic pregnancies. The absence of abdominal pain was the only clinically useful negative predictive value (91%) regarding tubal rupture. Although mean levels of serum human chorionic gonadotropin (hCG-beta subunit) were significantly higher in patients with ruptured versus unruptured ectopic pregnancies (16,612 mIU/mL vs 6406 mIU/mL), no breakpoint excluded the possibility of tubal rupture. In fact, one third of ectopic pregnancies in patients with a serum beta-hCG level below 100 mIU/mL were ruptured. We conclude that clinical symptoms and signs are poor predictors of tubal rupture. In addition, absolute values of serum beta-hCG are not helpful in excluding the possibility of rupture.
我们评估了245例经腹腔镜证实为异位妊娠患者的病史、体格检查及实验室检查结果。对于输卵管破裂，无腹痛是唯一具有临床意义的阴性预测值（91%）。虽然异位妊娠破裂患者血清人绒毛膜促性腺激素（β亚基）的平均水平显著高于未破裂患者（16,612 mIU/mL对6406 mIU/mL），但没有一个临界值能排除输卵管破裂的可能性。事实上，血清β-hCG水平低于100 mIU/mL的患者中，有三分之一的异位妊娠发生了破裂。我们得出结论，临床症状和体征对输卵管破裂的预测效果不佳。此外，血清β-hCG的绝对值无助于排除破裂的可能性。
