Department of Obstetrics and Gynecology and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the University of Southern California, Keck School of Medicine, Department of Obstetrics and Gynecology, Los Angeles, California; and the Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida.
Obstet Gynecol. 2013 Aug;122(2 Pt 1):337-343. doi: 10.1097/AOG.0b013e31829c6ed6.
To characterize the curve derived from serial human chorionic gonadotropin (hCG) values in women with spontaneous resolution of pregnancy of unknown location and to assess factors that modify the decline.
Data from three sites were extracted from a clinical database of women with a symptomatic pregnancy of unknown location that required follow-up with serial hCG levels. A nonlinear mixed-effects regression model was used to generate hCG elimination curves.
Four hundred forty-three women presenting with a pregnancy of unknown location that resolved without intervention were studied between September 2007 and May 2009. Women older than 35 years had a slower hCG decline (P=.001) and those with pain had a steeper decline (P=.006), but these changes did not alter the curve in a clinically meaningful way. The decline in hCG is faster for those with a higher level at presentation. The average decline of hCG in women with spontaneous resolution is slower than previously reported. However, the minimal decline in hCG for women with spontaneous resolution of a pregnancy of unknown location ranged from 35% to 50% at 2 days of follow-up and from 66% to 87% at 7 days, which is more rapid than previously reported.
In a diverse population, using updated statistical methods, it was observed that the minimal decline in hCG for women with spontaneous resolution is more rapid than previously reported. A decline slower than these thresholds may indicate the presence of retained trophoblastic tissue or ectopic pregnancy.
III.
描述自然消退妊娠不明位置患者的人绒毛膜促性腺激素（hCG）值序列曲线特征，并评估影响其下降的因素。
从 2007 年 9 月至 2009 年 5 月，从一个需要进行 hCG 水平连续监测的症状性妊娠不明位置患者的临床数据库中提取了来自三个地点的数据。采用非线性混合效应回归模型生成 hCG 消除曲线。
研究了 443 例未经干预自然消退妊娠不明位置的患者。年龄大于 35 岁的患者 hCG 下降速度较慢（P=.001），有疼痛的患者下降速度较快（P=.006），但这些变化并没有以有临床意义的方式改变曲线。就诊时 hCG 水平较高的患者 hCG 下降速度较快。自然消退患者 hCG 的平均下降速度比以前报道的要慢。然而，妊娠不明位置自然消退患者的 hCG 最小下降幅度在 2 天的随访时为 35%至 50%，在 7 天的随访时为 66%至 87%，比以前报道的更快。
在一个多样化的人群中，使用更新的统计方法观察到，自然消退患者的 hCG 最小下降幅度比以前报道的更快。下降速度低于这些阈值可能表明存在残留的滋养层组织或异位妊娠。
III。
