摘要
目的:探究剖宫产瘢痕妊娠患者血清β-人绒毛膜促性腺激素(β-hCG)、三碘甲状腺原氨酸(T)、甲状腺素(T)水平与子宫动脉栓塞术后再妊娠的关系。方法:选取2019年11月-2020年11月本院143例剖宫产瘢痕妊娠患者作为研究对象,依据术后3年再妊娠情况分为再妊娠组86例和未妊娠组57例,记录患者临床资料,采用化学发光法测定术前、术后第1、第3个月经周期血清β-hCG水平,采用ELISA法检测T_(3)、T_(4)水平。血清β-hCG、甲状腺激素水平与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的关系行logistic回归分析;绘制ROC曲线分析血清β-hCG、甲状腺激素水平预测剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的价值。结果:血清β-hCG、T_(3)、T_(4)水平在未妊娠组和再妊娠组及术后不同时间点存在交互效应(均P<0.05);术后血清β-hCG水平呈下降趋势,血清T_(3)、T_(4)水平呈上升趋势。术后第1、第3个月经周期再妊娠组的血清β-hCG水平均低于未妊娠组,血清T_(3)、T_(4)水平均高于未妊娠组(均P<0.05)。术后第1个月经周期血清β-hCG、T_(3)、T_(4)水平预测剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的AUC分别为0.827、0.816、0.830,低于三者联合预测的AUC为0.933(Z=2.543、2.807、2.471,均P<0.05)。术后第1、第3个月经周期的血清β-hCG、T_(3)、T_(4)水平均与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠有关,其中术后第1、第3个月经周期β-hCG为独立危险因素,T_(3)、T_(4)为保护因素(均P<0.05)。结论:子宫动脉栓塞术后第1个月经周期血清β-hCG、Ts、T4水平联合检测可一定程度预测再妊娠情况,进而指导临床治疗。
Objective:To investigate the relationship between serum levels of beta-human chorionic gonadotropin(β-hCG)triodothyronine 3(T),and thyroxine 4(T)in patients with cesarean scar pregnancy and re pregnancy after uterine artery embolization.Methods:A total of 143 patients with cesarean scar pregnancy in our hospital from November 2019 to November 2020 were regarded as the study subjects.They were separated into a re pregnancy group of86 cases and a non pregnancy group of 57 cases based on re pregnancy within 3 years after operation.Clinical data of the patients were recorded,chemiluminescence method was applied to measure serumβ-hCGlevel before surgery and during the first and third menstrual cycles after surgery,ELISA method was applied to detect T_(3),and T_(4),levels.The relationship between serumβ-hCG and thyroid hormone levels and re pregnancy after cesarean scar pregnancy with uterine artery embolization was analyzed using logistic regression;ROC curve was plotted to analyze the value of serumβ-hCG and thyroid hormone levels in predicting re pregnancy after cesarean scar pregnancy with uterine artery embolization.Results:There was an interactive effect of serumβ-hCG,T_(3),and T_(4),levels between the non pregnancy group and re pregnancy group,and among diferent postoperative time points(all P<0.05);Postoperative serumβ-hCG level showed a decreasing trend,while serumT_(3),andT_(4),levels showed an increasing trend.The serumβ-hCG level in the pregnant group during the first and third menstrual cycles after surgery were lower than those in the non pregnant group,while the serum T_(3),and T_(4),levels were higher than those in the non pregnant group(ll P<0.05).The AUC of serumβ-hCG,T,and T,levels in first menstrual cycle for predicting recurrent pregnancy after uterine artery embolization was 0.827,0.816,and 0.830,respectively,which were lower than the AUC of combined prediction,0.933(Z=2.543,2.807,2.471,all P<0.05).The serumβ-hCG,T,and Tlevels in the first and third menstrual cycles after surgery were all related to re pregnancy after cesarean scar pregnancy with uterine artery embolization,β-hCG in the first and third menstrual cycles after surgery was an independent risk factor,whileT_(3),andT_(4),were protective factors(all P<0.05).Conclusion:The combined detection of serumβ-hCG,T,and T,levels in the frst menstrual cycle afer uterine artery embolization can predict the situation of re pregnancy to a certain extent and guide clinical treatment.
作者
万霞
WAN Xia(Department of Clinical Laboratory Medicine,The people's hospital of Xintai city,Shandong Xintai 271200)
出处
《医学检验与临床》
2024年第9期1-5,14,共6页
Medical Laboratory Science and Clinics
