Mashiach Roy, Kislev Inbar, Gilboa Daniella, Mazaki-Tovi Shali, Seidman Daniel S, Goldenberg Mordechai, Bouaziz Jerome
Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel-Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel-Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Obstet Gynecol Reprod Biol. 2018 Dec;231:188-191. doi: 10.1016/j.ejogrb.2018.10.046. Epub 2018 Oct 26.
To determine the association between early increase in the serum hCG levels (days 0-4) and treatment success rates following methotrexate therapy in ectopic pregnancy patients.
A level II-2 case-control study of involving 140 patients treated with methotrexate for ectopic pregnancy at the gynecology department in a tertiary care hospital.
A logistic regression model for the "failure of treatment" was fitted with serum hCG levels change between day 0 and day 4, patient age, pregnancy age at day-0, and day-0 β-hCG level as predictors. The logistic regression analysis indicated that having more than 50% increase in the β-hCG levels between days 0 and 4 significantly (P = 0.011) increases the risk of MTX treatment failure.
The results of this study indicate that >50% increase in β-hCG levels between days 0 and 4 significantly increases the risk of methotrexate treatment failure. This novel information could assist patients and physicians in making decisions regarding ectopic pregnancy treatment.
确定异位妊娠患者血清人绒毛膜促性腺激素（hCG）水平早期升高（第0 - 4天）与甲氨蝶呤治疗成功率之间的关联。
一项二级2病例对照研究，涉及一家三级护理医院妇科接受甲氨蝶呤治疗异位妊娠的140名患者。
以第0天至第4天血清hCG水平变化、患者年龄、第0天的妊娠年龄和第0天的β - hCG水平作为预测指标，拟合了“治疗失败”的逻辑回归模型。逻辑回归分析表明，第0天至第4天β - hCG水平升高超过50%会显著（P = 0.011）增加甲氨蝶呤治疗失败的风险。
本研究结果表明，第0天至第4天β - hCG水平升高超过50%会显著增加甲氨蝶呤治疗失败的风险。这一新颖信息可协助患者和医生做出关于异位妊娠治疗的决策。
