孕激素及人绒毛促性腺激素与药物流产后异常子宫出血的关系

目的:分析孕激素和人绒毛膜促性腺激素(h CG)与药物流产后异常子宫出血的关系。方法:选择2017年1月至2017年12月我院妇产科收治的药物终止妊娠的妇女150例,患者口服米非司酮配伍米索前列醇药物终止早期妊娠。将药物流产后子宫出血时间≤14 d作为对照组(n=75),14d作为异常组(n=75)。比较两组患者在药物流产后10 d、14 d、18 d、22 d血清中孕激素和h CG含量,分析两组患者孕激素和h CG含量相关性。结果:两组患者在年龄、月经周期、孕次、受孕天数、体重等方面比较无统计学差异(P0.05)。异常组在药物流产后10 d、14 d、18 d、22 d血清孕激素和h CG含量均高于对照组(P0.05)。两组患者在药物流产后10 d、14 d、18 d、22 d孕激素含量呈先降低再升高的趋势(P0.05)。对照组患者在药物流产后10 d、14 d、18 d、22 d血清hCG含量逐渐降低(P0.05);异常组在药物流产后10 d、14 d血清h CG含量比较无统计学差异(P0.05),在药物流产后18 d、22 d血清hCG含量低于药物流产后10 d、14 d,且药物流产后22 d低于药物流产后18 d(P0.05)。对全部样本的全部时点数据合并进行Pearson相关检验分析,孕激素和h CG含量呈正相关关系(P0.05)。结论:药物流产后异常子宫出血妇女血清的孕激素、hCG含量较高,两者呈正相关关系。药物流产后10 d、14 d监测血清HCG值无明显下降提示有异常子宫出血的可能,联合监测孕激素、hCG含量有利于药物流产后异常子宫出血的预测和治疗。

Relationship between Progesterone and Human Chorionic Gonadotropin and Abnormal Uterine Bleeding after Medical Abortion

ABSTRACT Objective: To analyze the relationship between progesterone and human chorionic gonadotropin(hCG) and abnormal uterine bleeding after medical abortion. Methods: 150 women who terminated the pregnancy by medicine in the obstetrics and gynecology department of our hospital from January 2017 to December 2017 were selected, patients were given mifepristone combined with miso- prostol to terminate early pregnancy. After medical abortion, the uterine bleeding time was less than 14 d as control group(n=75), the uterine bleeding time was more than 14 d as abnormal group(n=75). The level of serum progesterone and hCG was compared between the two groups at 10 d, 14 d, 18 d, 22 d after medical abortion. The correlation between progesterone and hCG level in the two groups was analyzed. Results: There was no significant difference in age, menstrual cycle, gestational times, number of pregnant days and weight be- tween the two groups(P>0.05). 10 d, 14 d, 18 d, 22 d after medical abortion, serum progesterone level of abnormal group was significantly higher than that of control group(P<0.05).10 d, 14 d, 18 d, 22 d after medical abortion progesterone level decreased first and then in- creased between the two groups(P<0.05). 10 d, 14 d, 18 d, 22 d after medical abortion, the serum hCG level decreased gradually in the control group(P<0.05). There was no significant difference in serum hCG level at 10 d, 14 d after medical abortion in the abnormal group (P>0.05). The serum hCG level at 18 d, 22 d after medical abortion was lower than at 10 d, 14 d after medical abortion, and 22 d after medical abortion was lower than at 18 d after medical abortion (P<0.05). All the samples at different times were analyzed by Pearson cor- relation test, the level of progesterone was positively correlated with hCG level(P<0.05). Conclusion: The level of serum progesterone and hCG of women with abnormal uterine bleeding after medical abortion is higher, and they have a positive correlation. There is no sig- nificant decrease in serum HCG level at 10 d, 14 d after medical abortion, suggesting the possibility of abnormal uterine bleeding. The combined monitoring of progesterone and hCG level is beneficial to the prediction and treatment of abnormal uterine bleeding after med- ical abortion.