人绒毛膜促性腺激素、孕酮、甲胎蛋白和雌二醇在异位妊娠诊断中的应用
hCG, progesterone, alpha-fetoprotein, and estradiol in the identification of ectopic pregnancy.
作者信息
Grosskinsky C M, Hage M L, Tyrey L, Christakos A C, Hughes C L
机构信息
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
出版信息
Obstet Gynecol. 1993 May;81(5 ( Pt 1)):705-9.
OBJECTIVE
To enhance the laboratory diagnosis of ectopic pregnancy by determining levels of hCG, progesterone, estradiol (E2), and alpha-fetoprotein (AFP).
METHODS
Serum samples and medical records were retrospectively analyzed from 100 gynecologic patients for whom quantitative hCG determination had been ordered. Clinical data and levels of hCG, progesterone, E2, and AFP were examined by univariate and multivariate logistic analyses.
RESULTS
Progesterone, hCG, and E2 were highest in viable pregnancies, whereas AFP tended to be higher in ectopic pregnancies. A single progesterone value could differentiate between ectopic and viable pregnancy in more than 80% of patients. The combination of all four biochemical markers predicted ectopic pregnancy with 98.5% specificity and 94.5% accuracy. Clinical diagnosis was less than 75% accurate.
CONCLUSION
A combination of biochemical markers including hCG, progesterone, E2, and AFP can be superior to a single progesterone level or clinical evaluation in the diagnosis of ectopic pregnancy.
目的
通过测定人绒毛膜促性腺激素（hCG）、孕酮、雌二醇（E2）和甲胎蛋白（AFP）水平来加强异位妊娠的实验室诊断。
方法
回顾性分析100例接受定量hCG检测的妇科患者的血清样本和病历。通过单因素和多因素逻辑分析检查临床数据以及hCG、孕酮、E2和AFP水平。
结果
孕酮、hCG和E2在活胎妊娠中最高，而AFP在异位妊娠中往往较高。单一孕酮值可在超过80%的患者中区分异位妊娠和活胎妊娠。所有四种生化标志物联合预测异位妊娠的特异性为98.5%，准确性为94.5%。临床诊断的准确性低于75%。
结论
在异位妊娠诊断中，包括hCG、孕酮、E2和AFP在内的生化标志物联合检测可能优于单一孕酮水平检测或临床评估。
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