【作者】 石清蒲；

【导师】 孙雪梅； 赵晶；

【作者基本信息】 山东大学 ， 妇产科学， 2006， 硕士

【摘要】 背景目的 目前，异位妊娠早期诊断主要依靠超声和系列的血清人绒毛膜促性腺激素β亚单位(β-HCG)化验检查，但是在孕4-5周时，对于诊断宫内妊娠或异位妊娠来说，即使高分辨率的阴道超声检查，想在影像学上得到明确的孕囊图像均太早，且宫腔内的假孕囊和蜕膜征易误诊。在异位妊娠时，β-HCG变异范围(标准差)较大，使异位妊娠和宫内妊娠之间的β-HCG水平有较大范围的重叠，仅单次测定血清β-HCG作为一个诊断指标对于异位妊娠的早期诊断价值不大。本研究旨在检测人绒毛膜促性腺激素游离β亚单位(F-β-HCG)、孕酮(PROG)、肌酸激酶(CK)、β-HCG在异位妊娠早期诊断中的灵敏度和特异度，探讨F-β-HCG、PROG、CK、β-HCG在异位妊娠早期诊断中的意义。 方法 研究对象：自2005年1月至2005年10月山东省立医院门诊收治的符合纳入标准的患者80例作为研究对象，纳入标准：①平素月经周期规律，末次月经日期明确，停经30～60天；②年龄为20～40岁；③尿妊娠试验阳性；④B超未能确定妊娠位置；⑤不规则阴道出血排除宫颈息肉和／或宫颈糜烂；⑥肝肾功能正常；⑦生命体征正常；⑧患者知情同意。 对于符合纳入标准的患者，治疗前均抽取静脉血，离心，吸取离心后的血清2ml，其中1ml立即进行β-HCG、PROG、CK测定；1ml置于-20℃的冰箱内保存待检F-β-HCG，同时记录患者的姓名、年龄、孕产史、孕龄、联系方式等并追踪观察。根据最后的妊娠结局或组织学检查将研究对象分为两组：A组为宫内妊娠组：B组为异位妊娠组。 血清β-HCG，PROG采用电化学发光法测定，血清CK采用连续监测酶法更多还原

【Abstract】 Background/aimsThe most common methods of Early diagnosis of ectopic pregnancy(EP) are using ultrasound with serial measurements of P-human chorionic gonadotropin (HCG). Using ultrasound can not find the embryo as early as pregnancy 4-5 weeks, not only for EP, but also for intrauterine pregnancy. Furthermore the false embryo often leads to misdiagnosis. And many researches have shown that in the early phase of pregnancy the difference of β-HCG is not obvious between EP and intrauterine pregnancy. So β-HCG is not enough in the diagnosis of early EP. The objective of this study was to explore the possibility that an isolated measurement of F-β-HCG, CK, PROG rather than β-HCG could be used as a single test for ectopic pregnancy, and the significant of compound of F-β-HCG, PROG, β-HCG in the diagnosis of ectopic pregnancy. MethodsFrom January 2005 to October 2005, serum samples were collected at the outpatient departments of Shandong Shengli Hospital. The selective criteria were as follows: ①Regular menstrual cycle; clear last menstrual period (LMP):30d-60d; ②20-40 years old;③with a positive pregnancy test;④with inconclusive ultrasonogr-aphic findings;⑤the pregnant woman who has cervical polyp or cervical erosion was excluded;⑥The function of liver, kidney is normal;⑦willingness;⑧hemodynamic stability.There were 80 cases that meet the above criteria altogether. The blood更多还原