Wilcox A J, Weinberg C R, Wehmann R E, Armstrong E G, Canfield R E, Nisula B C
Fertil Steril. 1985 Sep;44(3):366-74.
We intensively studied 30 women attempting pregnancy in order to lay groundwork for larger studies of early pregnancy loss. These women collected first morning urine specimens for up to 6 months after discontinuing use of birth control. Urine specimens were successfully collected for 98% of the woman-days in the study. Three assays for human chorionic gonadotropin (hCG) were performed on each urine specimen. An immunoradiometric assay (IRMA) specific to the carboxyterminal peptide of the hCG beta-chain proved to be more sensitive and more specific than two radioimmunoassays (RIAs). Using the IRMA, we found four cases in which hCG rose and fell over successive days, consistent with early pregnancy loss. For three of these four cases, the level of hCG was too low to be detectable with the RIAs. Among the control group of five women with tubal ligations, there was no detectable hCG above threshold with the IRMA. Thus, the enhanced sensitivity and specificity of the IRMA allows very early pregnancy losses to be identified that would otherwise be undetectable. Furthermore, its effectiveness with small quantities of first morning urine makes the IRMA a useful tool for epidemiologic studies.
我们对30名尝试怀孕的女性进行了深入研究，以便为早期妊娠丢失的更大规模研究奠定基础。这些女性在停止使用避孕药后长达6个月的时间里收集晨尿样本。在研究中，98%的女性日成功收集到了尿液样本。对每个尿液样本进行了三种人绒毛膜促性腺激素（hCG）检测。一种针对hCGβ链羧基末端肽的免疫放射分析（IRMA）被证明比两种放射免疫分析（RIA）更敏感、更特异。使用IRMA，我们发现有4例hCG在连续几天内先上升后下降，这与早期妊娠丢失相符。在这4例中的3例中，hCG水平过低，用RIA检测不到。在5名接受输卵管结扎的女性组成的对照组中，用IRMA检测未发现高于阈值的可检测hCG。因此，IRMA更高的灵敏度和特异性能够识别出那些原本无法检测到的极早期妊娠丢失。此外，它对少量晨尿的有效性使IRMA成为流行病学研究的有用工具。
