Obstetrics and Gynecology Department, Suez Canal University, Ismailia, Egypt.
J Matern Fetal Neonatal Med. 2020 Jul;33(14):2403-2407. doi: 10.1080/14767058.2018.1551353. Epub 2019 Jan 4.
To evaluate the role of β-HCG level changes between days 0 and 1 as an early predictor of methotrexate success in cases of tubal ectopic pregnancy. A retrospective study included 86 tubal ectopic pregnancies treated with a single-dose methotrexate protocol of 50 mg/m of body surface. β-HCG measurements were taken on days 0, 1, 4 and 7 where day 0 is the day of methotrexate injection. Day 0 β-HCG and the percentage change in β-HCG level between days 0 and 1 (HCG index) were calculated and compared between patients who were successfully or unsuccessfully treated. Receiver operator characteristics (ROC) curves were plotted to identify the best cutoff levels. The average level of β-HCG (1416.8 versus 2502.5 IU/L, =.001) and its increment after 24 hours (12.9 versus 27.1%, =.001) were significantly lower in the successful treatment group. ROC curves for β-HCG level and its relative increment revealed that cutoff values of ≤1550 IU/L and ≤13% increment showed a sensitivity of 90 and 70% respectively for successful methotrexate treatment. Day 0 β-HCG level ≤1550 IU/L and an increment of ≤13% after 24 hours are early predictors of successful methotrexate treatment for tubal ectopic pregnancy.
评估β-HCG 水平在 0 天和 1 天之间的变化作为单次甲氨蝶呤治疗输卵管妊娠成功的早期预测指标。一项回顾性研究纳入了 86 例接受单次甲氨蝶呤 50mg/m 体表面积方案治疗的输卵管妊娠患者。β-HCG 测量在第 0、1、4 和 7 天进行，第 0 天是甲氨蝶呤注射的日子。计算第 0 天β-HCG 和第 0 天与第 1 天之间β-HCG 水平的变化百分比（HCG 指数），并比较成功和未成功治疗的患者。绘制受试者工作特征（ROC）曲线以确定最佳截断值。成功治疗组的β-HCG 平均水平（1416.8 与 2502.5IU/L，=.001）及其 24 小时后的增量（12.9 与 27.1%，=.001）明显较低。β-HCG 水平及其相对增量的 ROC 曲线显示，截断值≤1550IU/L 和≤13%的增量对成功的甲氨蝶呤治疗具有 90%和 70%的敏感性。第 0 天β-HCG 水平≤1550IU/L 和 24 小时后增加≤13%是输卵管妊娠成功接受甲氨蝶呤治疗的早期预测指标。
