Gynecology Department, The Third Affiliated Hospital of Sun Yat-Sen University, 600# Tianhe Road, Guangzhou, People's Republic of China.
Arch Gynecol Obstet. 2023 Jul;308(1):143-148. doi: 10.1007/s00404-023-06998-7. Epub 2023 Mar 26.
Ectopic pregnancy is a life-threatening disease and is an important cause of pregnancy-related mortality. MTX is the primary conservative treatment medicine of ectopic pregnancy, and mifepristone is also a promising medicine. Through studying the ectopic cases at the third affiliated hospital of Sun Yat-Sen University, the study aims to analyze the indication and treatment outcome predictors of mifepristone.
The data of 269 ectopic pregnancy cases treated with mifepristone during the year 2011-2019 were retrospectively collected. Logistic-regression analysis was used to analyze the factors affiliated with the treatment outcome of mifepristone. Then ROC curve was used to analyze the indication and predictors.
Through logistic-regression analysis, HCG is the only factor related to the treatment outcome of mifepristone. The AUC of ROC curve predicting treatment outcome with pre-treatment HCG is 0.715, and the cutoff value of ROC curve is 372.66 (sensitivity 0.752, specificity 0.619). The AUC of 0/4 ratio predicting the treatment outcome is 0.886, and the cutoff value is 0.3283 (sensitivity 0.967, specificity 0.683). The AUC of 0/7 ratio is 0.947, and the cutoff value is 0.3609 (sensitivity 1, specificity 0.828).
Mifepristone can be used to treat ectopic pregnancy. HCG is the only factor related to the treatment outcome of mifepristone. Patients with HCG less than 372.66 U/L can be treated by mifepristone. If HCG descends more than 67.18% on the 4th day or 63.91% on the 7th day, it is more likely to have a successful treatment outcome. It is more precise to retest on the 7th day.
宫外孕是一种危及生命的疾病，也是妊娠相关死亡的重要原因。MTX 是宫外孕的主要保守治疗药物，米非司酮也是一种有前途的药物。通过对中山大学附属第三医院的宫外孕病例进行研究，本研究旨在分析米非司酮的适应证和治疗结果预测因素。
回顾性收集了 2011 年至 2019 年期间 269 例接受米非司酮治疗的宫外孕病例数据。采用 logistic 回归分析米非司酮治疗结果相关因素。然后使用 ROC 曲线分析适应证和预测因素。
通过 logistic 回归分析，HCG 是唯一与米非司酮治疗结果相关的因素。预测治疗结果的 ROC 曲线中 HCG 的 AUC 为 0.715，ROC 曲线的截断值为 372.66（灵敏度 0.752，特异性 0.619）。0/4 比值预测治疗结果的 AUC 为 0.886，截断值为 0.3283（灵敏度 0.967，特异性 0.683）。0/7 比值的 AUC 为 0.947，截断值为 0.3609（灵敏度 1，特异性 0.828）。
米非司酮可用于治疗宫外孕。HCG 是唯一与米非司酮治疗结果相关的因素。HCG 小于 372.66 U/L 的患者可以用米非司酮治疗。如果第 4 天 HCG 下降超过 67.18%，或第 7 天 HCG 下降超过 63.91%，则更有可能获得成功的治疗结果。第 7 天复测更为准确。
