异位妊娠甲氨蝶呤治疗后血β-HCG变化临床分析(1)
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[摘要] 目的：探讨异位妊娠患者甲氨蝶呤(MTX)化疗后血β-HCG变化特点。方法：回顾分析2008年1月～2009年12月甲氨蝶呤治疗异位妊娠患者40例。将治疗期间血β-HCG值变化分别绘制成曲线图，并按图形不同特点分为3组，即失败组、下降组和折线组。统计患者年龄、停经天数、血β-HCG值、入院期间B超所示附件区包块的最大径线、血β-HCG峰值与峰值前谷值比率、治疗总天数等。结果：失败组与折线组血β-HCG峰值与峰值前谷值比率差异有统计学意义(P<0.05)；折线组治疗总天数明显多于下降组，差异有统计学意义(P<0.05)。结论：血β–HCG变化特点，对甲氨蝶呤治疗异位妊娠的疗效判定、治疗方案调整、用药指导等有指导意义。
[关键词] 异位妊娠；保守治疗；甲氨蝶呤；血清β-HCG值
[中图分类号] R714.22 [文献标识码] B [文章编号] 1674-4721(2011)11(c)-072-02
Analysis of β-HCG change of MTX chemotherapy on ectopic pregnancy
AO Mingzhu, HU Dongyang, CUI Min
Obstetrics and Gynecology Hospital in Dalian City, Liaoning Province, Dalian 116000, China
[Abstract] Objective: To discuss blood β-HCG change characteristic of ectopic pregnancy patient after MTX treatment. Methods: Retrospectively analyzed the conservative treatment of ectopic pregnancy with methotrexate in 40 patients from January 2008 to December 2009. Serum β-HCG values during treatment were plotted into curves and were divided into 3 groups according to the pattern characteristics, namely failure group, descent group and broken line group. Each group was analyzed in its patient age, menopausal days, serum beta-HCG value, maximum diameter of adnexal mass, serum beta-HCG peak and peak valley ratio, the total treatment days etc. Results: β-HCG ratio of peak to valley of failure group and broken line group was significantly different (P<0.05); The total treatment days of broken line group were more than the descent group, there were significant differences (P<0.05). Conclusion: The various tendency of the serum β-HCG curve has important significance in MTX treatment for ectopic pregnancy, such as curative effect judgment, treatment plan adjustment, medication guide, and so on.
[Key words] Ectopic pregnancy; Conservative treatment; Methotrexate; Serum β-HCG
异位妊娠是常见妇科疾病，近年来其发生率呈明显上升趋势。传统的手术治疗对异位妊娠的治疗虽然可靠，但对于未婚未育者、妊娠早期无生命危险者及希望生育者则欠妥。随着高敏感的放免法测定血清β-HCG和阴道超声的广泛应用，异位妊娠得以早期诊断，为保守治疗提供了可能。而保守治疗后监测血清β-HCG水平对于保守性治疗疗效的判定极为重要。本文对40例经甲氨蝶呤(MTX)保守治疗的异位妊娠患者治疗前后血清β-HCG的变化进行分析，以探讨MTX治疗异位妊娠后血清β-HCG变化特点，以期根据血清β-HCG值的变化 ......
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