血清β-hCG变化百分比在甲氨蝶呤治疗异位妊娠疗效评价中的价值

发布时间：2019-05-22 09:27

【摘要】：目的探讨血清β-h CG变化百分比在甲氨蝶呤(MTX)治疗异位妊娠(EP)疗效评价中的价值。方法选取EP患者138例,采用单独MTX肌内注射(50 mg/m2)治疗,根据公式计算每例患者血清β-h CG在MTX治疗1、4、7 d后的变化百分比。结果 MTX治疗4 d后血清β-h CG的中位值下降达55.8%的病例中89.6%治疗有效。MTX治疗EP成功105例(76.3%,成功组),失败33例(23.7%,失败组)。成功组中血清β-h CG变化百分比在治疗1、4、7d后下降的例数占治疗成功人数的比例分别为54.3%、63.4%、85.1%。ROC曲线分析结果显示,治疗1 d后血清β-h CG变化百分比的ROC曲线下面积是0.63(95%CI为0.49~0.76;P0.05),敏感度为52.9%,特异度为65.0%,阳性预测值(PPV)为45.6%,阴性预测值(NPV)为55.2%。治疗4 d后血清β-h CG变化百分比的ROC曲线下面积为0.69(95%CI为0.58~0.82;P0.05),敏感度为61.8%,特异度为70.0%,PPV为47.6%,NPV为53.1%。治疗7 d后血清β-h CG变化百分比ROC曲线下面积为0.79(95%CI为0.68~0.91;P0.05),敏感度为83.8%,特异度为60.0%,PPV为58.9%,NPV为41.7%。结论治疗4 d后的血清β-h CG变化百分比可预测MTX治疗EP的疗效及判断EP患者对MTX单剂量治疗的敏感性。
[Abstract]:Objective to investigate the value of serum 尾-h CG in evaluating the efficacy of methotrexate (MTX) in the treatment of ectopic pregnancy (EP). Methods 138 patients with EP were treated with intramuscular injection of MTX alone (50 mg/m2). The percentage of serum 尾-h CG in each patient treated with MTX for 1, 4 and 7 days was calculated according to the formula. Results the median value of serum 尾-h CG decreased by 55.8% after 4 days of MTX treatment, 89.6% of the cases were effective. 105 cases (76.3%, successful group) of EP were successfully treated with MTX, 33 cases (23.7%) failed, and 33 cases (23.7%) failed. The percentage of serum 尾-h CG in the successful group was 54.3%, 63.4% and 85.1%, respectively, and the results of ROC curve analysis showed that the percentage of serum 尾-h CG decreased after 7 days of treatment was 54.3%, 63.4% and 85.1%, respectively. After 1 day of treatment, the area under the ROC curve of the percentage change of serum 尾-h CG was 0.63 (95%CI 0.49 鈮，

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