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[各种妊娠终止后滋养层细胞活力的研究(作者译)]

[Studies on the viability of trophoblast after termination of various kinds of pregnancies (author's transl)].

作者信息

Kanda K

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1980 Oct;32(10):1575-82.

PMID:6263995
Abstract

Although normal value of hCG (LH level) does not necessarily indicate eradication of viable trophoblast, its confirmation has been demonstrated as a clinically useful guide for the probable prevention of choriocarcinoma after hydatidiform mole by Takeuchi et al. Choriocarcinoma preceded by other pregnancies than hydatidiform mole which has the highest risk for choriocarcinoma has drawn more attention than before in connection with the decrease of postmolar choriocarcinoma. So that I have studied the regression rate of urinary gonadotropin (hCG) after the termination of various kinds of pregnancies. In 2,433 cases of induced abortion, 695 cases of spontaneous abortion, 1,724 cases of term delivery and 43 cases of hydatidiform mole, their urinary hCG were determined to the level of physiological range of LH. The rate of hCG regression was in the order of term delivery, spontaneous abortion, induced abortion and hydatidiform mole. The younger was the gestational age of trophoblast, the slower was the regression of hCG. At one month after the termination of pregnancy, 80.1%, 11%, 0.3%, 8% and 4.1%, and at two month 55.8%, 1.6%, 0.5%, 4% and 0.5% for hydatidiform mole, induced abortion of less than 12 week of gestation, spontaneous abortion of less than 12 week of gestation, spontaneous abortion of between 13 and 20 week of gestation respectively still showed abnormal hCG value. One percent of induced abortion at 5 month, 4% of spontaneous abortion at 3 month, 0.3% of term delivery at 4 month still maintained abnormal titer. No malignant sequelae in patients under the investigation have ever been observed in the follow up period between 3 and 8 years.

摘要

虽然人绒毛膜促性腺激素(LH水平)的正常数值并不一定表明存活的滋养层已被清除,但Takeuchi等人已证明,其数值的确认可作为临床上预防葡萄胎后绒毛膜癌的有用指导。与绒毛膜癌风险最高的葡萄胎相比,由其他妊娠引发的绒毛膜癌,随着葡萄胎后绒毛膜癌发病率的下降,已受到越来越多的关注。因此,我研究了各类妊娠终止后尿促性腺激素(hCG)的下降速率。在2433例人工流产、695例自然流产、1724例足月分娩和43例葡萄胎病例中,测定了其尿hCG水平,直至达到LH的生理范围。hCG下降速率依次为足月分娩、自然流产、人工流产和葡萄胎。滋养层的孕周越小,hCG下降越慢。妊娠终止后1个月时,葡萄胎、妊娠12周以内人工流产、妊娠12周以内自然流产、妊娠13至20周自然流产的hCG异常值分别为80.1%、11%、0.3%、8%和4.1%;2个月时分别为55.8%、1.6%、0.5%、4%和0.5%。妊娠5个月时人工流产的1%、妊娠3个月时自然流产的4%、妊娠4个月时足月分娩的0.3%仍维持异常水平。在3至8年的随访期内,未观察到受调查患者出现恶性后遗症。

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