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早孕期重复血清 kisspeptin 测量的预后价值:一项初步研究。

Prognostic value of repeated serum kisspeptin measurements in early first trimester pregnancy: a preliminary study.

机构信息

Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan Shandong 250012, People's Republic of China.

Department of Critical Care Medicine, Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, People's Republic of China.

出版信息

Reprod Biomed Online. 2019 Mar;38(3):465-471. doi: 10.1016/j.rbmo.2018.11.014. Epub 2018 Dec 7.

Abstract

RESEARCH QUESTION

What is the diagnostic value of maternal kisspeptin in patients with asymptomatic first-trimester pregnancies, and what is the prognostic significance of kisspeptin versus beta-HCG in early pregnancies.

DESIGN

Case-control study in academic medical centres. Patients with no confounding co-morbidities who conceived by IVF and intracytoplasmic sperm injection were analysed. Maternal serum samples were assessed at the time of pregnancy testing. Women who achieved a positive pregnancy test were asked to take serum samples 4 days later. According to the follow-up results, patients who experienced biochemical pregnancy loss (n = 24) and early miscarriage (n = 21), and women who achieved a viable pregnancy (n = 28), were included in this study. Serum samples were collected to detect kisspeptin and beta-HCG, respectively.

RESULTS

Single serum determinations of kisspeptin and beta-HCG were correlated with the different pregnancy outcomes. Women who experienced biochemical pregnancy loss showed lower kisspeptin levels than those in groups B and C. No significant difference, however, was observed at the time of pregnancy testing in women who had experienced early miscarriage and those who had achieved viable pregnancy. Sequential measurements of serum kisspeptin are not as effective as beta-HCG in determining pregnancy outcome. Increased kisspeptin level was associated with reduced miscarriage risk.

CONCLUSION

Single serum measurement of kisspeptin is significantly altered in pregnant and non-pregnant women. However, it failed to discriminate between miscarriage and ongoing pregnancies in first-trimester pregnancy. Neither single nor sequential kisspeptin have higher diagnostic performance for miscarriage than beta-HCG in early stage.

摘要

研究问题

母体 kisspeptin 在无症状的早期妊娠患者中的诊断价值,以及 kisspeptin 与β-HCG 在早期妊娠中的预后意义。

设计

学术医疗中心的病例对照研究。分析无混杂合并症的通过体外受精和胞浆内精子注射受孕的患者。在妊娠检测时评估母体血清样本。获得阳性妊娠试验的女性被要求在 4 天后采集血清样本。根据随访结果,将经历生化妊娠丢失(n=24)和早期流产(n=21)的患者以及获得可存活妊娠的患者(n=28)纳入本研究。采集血清样本以分别检测 kisspeptin 和β-HCG。

结果

单次血清 kisspeptin 和β-HCG 测定与不同的妊娠结局相关。经历生化妊娠丢失的女性的 kisspeptin 水平低于 B 组和 C 组。然而,在经历早期流产和获得可存活妊娠的女性中,在妊娠检测时并未观察到明显差异。血清 kisspeptin 的连续测量不如β-HCG 确定妊娠结局有效。升高的 kisspeptin 水平与降低的流产风险相关。

结论

在妊娠和非妊娠女性中,单次血清 kisspeptin 测量显著改变。然而,它未能区分早期妊娠中的流产和持续妊娠。无论是单次测量还是连续测量,kisspeptin 对流产的诊断性能均不如β-HCG 在早期阶段高。

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