冻胚移植术后血清β-HCG值对妊娠结局的早期预测价值

发布时间：2018-03-22 18:54

本文选题：冻胚移植术　切入点：胚胎天数　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的探讨冻胚移植术后胚胎天数(embryonic day,ED)15-20时血清β-HCG值对妊娠结局的早期预测价值。方法回顾性分析在我院行冻胚移植的1600个周期,将妊娠结局分为三组:单胎活产组、双胎活产组和非活产组。运用t-检验分析不同妊娠结局间血清β-HCG值有无统计学差异,运用受试者工作特性曲线(ROC)分析血清β-HCG值预测单胎活产与双胎活产的界值。结果1.ED15-20,单胎活产组与双胎活产组的血清β-HCG值均高于非活产组,差异有统计学意义(P0.001);双胎活产组的血清β-HCG值均高于单胎活产组,差异有统计学意义(P0.001)。2.ED15时,将血清β-HCG界值定为174.5IU/L,具有最佳的单胎活产预测价值(敏感性:79.0%,特异性:84.6%,AUC:0.858);ED16 时,将血清 β-HCG界值定为216.5IU/L时,具有最佳的单胎活产预测价值(敏感性:84.7%,特异性:77.7%,AUC:0.881);ED17 时,将血清 β-HCG 界值定为 271.5IU/L 时,具有最佳的单胎活产预测价值(敏感性:86.9%,特异性:78.9%,曲线下面积:0.882);ED18时,将β-HCG界值定为426IU/L时,具有最佳的单胎活产预测价值(敏感性:86.1%,特异性:77.0%,AUC:0.907);ED19 时,将 β-HCG 界值定为 594IU/L时,具有最佳的单胎活产预测价值(敏感性:87.6%,特异性:83.3%,AUC:0.911);ED20时,将血清β-HCG界值定为872IU/L时,具有最佳的单胎活产预测价值(敏感性:83.5%,特异性:86.6%,AUC:0.888)。3.ED15时,将血清β-HCG界值定为401.0IU/L时,具有最佳的双胎活产预测价值(敏感性:66.1%,特异性:71.4%,AUC:0.757);ED16时,将血清β-HCG界值定为603.5IU/L时,具有最佳的双胎活产预测价值(敏感性:81.5%,特异性:70.2%,AUC:0.836);ED17 时,将血清 β-HCG 界值定为 842.5IU/L 时,具有最佳的双胎活产预测价值(敏感性:77.6%,特异性:71.9%,AUC:0.818);ED18时,将β-HCG界值定为1251.0IU/L时,具有最佳的双胎活产预测价值(敏感性:74.5%,特异性:64.2%,AUC:0.777);ED19时将血清β-HCG界值定为1876IU/L时,具有最佳的双胎活产预测价值(敏感性:80%,特异性:69.5%,AUC:0.817);ED20时,将血清β-HCG界值定为3186.0IU/L时,具有最佳的双胎活产预测价值(敏感性:82.6%,特异性:82.5%,AUC:0.894)。结论1.单胎活产组与双胎活产组的ED15-20血清β-HCG值均大于非活产组,差异有统计学意义(P0.001),双胎活产组的ED15-20血清β-HCG值均大于单胎活产组,差异有统计学意义(P0.001);2.ED19时,当血清β-HCG界值定为594IU/L时,具有最佳的预测单胎活产的价值,敏感性为87.6%,特异性为83.3%,曲线下面积为0.911;3.ED20时,当血清β-HCG界值定为3186IU/L时,具有最佳的预测双胎活产的价值,敏感性为82.6%,特异性为82.5%,曲线下面积为0.894);4.冻胚移植术后可用ED15-20血清β-HCG值来预测单胎活产与双胎活产,但预测双胎活产的准确性低于单胎活产.
[Abstract]:Objective to investigate the early predictive value of serum 尾 -HCG level in the embryo days after cryogenic embryo transplantation at 15-20 hours after cryogenic embryo transplantation. Methods the pregnancy outcome was divided into three groups: single live delivery group by retrospective analysis of 1600 cycles of frozen embryo transplantation in our hospital. The serum 尾 -HCG levels in twin live delivery group and non-live delivery group were analyzed by t- test, and whether there were statistical differences in serum 尾 -HCG between different pregnancy outcomes, Results 1. ED15-20, the serum 尾 -HCG value of single live birth group and twin live labor group was higher than that of non-live birth group, the serum 尾 -HCG value of single live birth group and twin live birth group was higher than that of non-live birth group. The serum 尾 -HCG of twin live labor group was significantly higher than that of single live birth group, and the serum 尾 -HCG boundary value was 174.5 IUP / L at P0.001U 路2.ED15, which had the best predictive value (sensitivity: 79.0, specificity: 84.6AUC: 0.858 / ED16). When the serum 尾 -HCG boundary is defined as 216.5IU/L, it has the best predictive value of single live birth (sensitivity: 84.7), specificity: 77.7% AUC: 0.881 / ED17, and serum 尾 -HCG as 271.5IU/L. Having the best predictive value of single live birth (sensitivity: 86.9, specificity: 78.9, area under the curve: 0. 882 / ED18), when 尾 -HCG is defined as 426IU/L, when the sensitivity is 86.1, the specificity is 77.0 / AUC / 0.907N / ED19, when 尾 -HCG is defined as 594IU/L, Having the best predictive value of single live birth (sensitivity: 87.6, specificity: 83.3), when the serum 尾 -HCG threshold is determined as 872IU/L, and when the serum 尾 -HCG threshold is determined as 872IU/L, when the sensitivity is 83.5, the specificity is 86.6% AUC: 0.888.3.ED15, the serum 尾 -HCG threshold is defined as 401.0IU/L. When the serum 尾 -HCG threshold is determined as 603.5IU/L, and when the sensitivity is 81.5 and the specificity is 70.2 / 0.836ED17, when the serum 尾 -HCG threshold is determined as 603.5IU/L, the serum 尾 -HCG bound value is defined as 842.5IU/L when the sensitivity is 66.1, the specificity is 71.4% and AUC: 0.757 / ED16. When the 尾 -HCG threshold is determined to be 1251.0IU/L, and the sensitivity is 74.5, the specificity is 64.2% when AUC: 0.777ED19, the serum 尾 -HCG threshold is defined as 1876IU/L, and the 尾 -HCG threshold is defined as 1876IU/L when the sensitivity is 77.6, the specificity is 71.9, and the ED18 is higher than that of AUC: 0.818. When the 尾 -HCG threshold is determined as 1251.0IU/L, the sensitivity is 74.5, and the specificity is 64.2 / 0.777ED19 when the 尾 -HCG threshold is defined as 1876IU/L. Having the best predictive value for twin live births (sensitivity: 80, specificity: 69.5, AUC: 0.817 / ED20, when the serum 尾 -HCG threshold is set as 3186.0IU/L, It has the best predictive value (sensitivity: 82.6, specificity: 82.5) and AUC: 0.894Conclusion 1.The serum 尾 -HCG values of single live birth group and twin live birth group are higher than those of non-live birth group. The serum 尾 -HCG value of twin live delivery group was higher than that of single live birth group. The difference was statistically significant when P0.001 / 2. ED19. When the serum 尾 -HCG boundary value was determined as 594IU/L, it had the best value to predict single live birth. When the sensitivity is 87.6, the specificity is 83.3 and the area under the curve is 0.9113.ED20, when the serum 尾 -HCG boundary value is determined as 3186IU/L, it has the best value of predicting twin live birth. The sensitivity was 82.6, the specificity was 82.5 and the area under the curve was 0.8940.After frozen embryo transplantation, the serum 尾 -HCG value of ED15-20 could be used to predict live birth of single fetus and twin fetus, but the accuracy of predicting live birth of twin fetus was lower than that of live birth of single fetus.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.8

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