| Objective To investigate the significance of detecting serum progesterone (P),humanchorionic gonadotropin(HCG) and carbohydrate antigen125(CA125) in predicting tocolytictreatment outcome of threatened abortion and provide objective and reasonable basis fortocolytic therapy.To explore the effect of maternal age, history of spontaneous abortion,history of artificial abortion on treatment outcome of patients with threatened abortion.Methods According to the standard of internalizing and removing,140patients withthreatened abortion in the affiliated hospital of ningxia medical university from April,2012toDecember,2012were selected.①The age, gestational weeks and pregnancy history of eachpatient was recorded, the levels of serum P,HCG and CA125were detected.②Tocolytictreatment was given to patients, the treatment outcome was followed-up, including continuedgestation and Spuc failure.③The effects of age, the history of spontaneous abortion and thehistory of artificial abortion on treatment outcome of threatened abortion were analyzed.Theserum index levels of patients whose treatment outcome were different were compared, thepredictive values of serum P level and serum CA125level for treatment outcome ofthreatened abortion were analyzed.Results For these140patients,136cases were given tocolytic treatment.104caseswere treated successfully and32cases were failed.①There was no significance in age ofwomen who aborted compared with the non-aborted women(P＞0.05).The success rate ofpatients whose ages were below35years old was obviously higher than the patients whoseages were great than or equal to35years old(P＜0.05).②The success rate among the3group of patients whose times of spontaneous abortion were0,1and great than or equal to2 were not obviously different.③The success rate among the3group of patients whose timesof artificial abortion were0,1and great than or equal to2were not obviously different.④The serum P level before treatment of patients whose treatment outcomes were successful andunsuccessful were respectively24.84±8.57ng/ml,10.37±5.69ng/ml.The former was higherthan the latter(P＜0.001).⑤The serum CA125level before treatment of patients whosetreatment outcomes were successful and unsuccessful were respectively30.83±11.93IU/ml,65.23±22.39IU/ml. The former was lower than the latte(rP＜0.001).⑥The serum HCG levelof patients whose treatment outcomes were successful and unsuccessful were respectively47083.75±29082.49mIU/ml and9637.31±6269.28mIU/ml. The former was higher than thelatte(rP＜0.001).⑦By the multiple factors logistic regression analysis, the age, the historyof spontaneous abortion and artificial abortion had no effect on the treatment outcome(P＞0.05). Serum P,HCG and CA125could affect the treatment outcome(P＜0.05).⑧According to the ROC curve, serum P≥12.23ng/ml was determined to the standard ofsuccess, and its sensitivity, specificity, false negative rate, false positive rate, Youden’s index,positive likelihood ratio, negative likelihood ratio, positive predictive value, negativepredictive value was85.58%,87.50%,14.42%,12.50%,73.08%,6.85,0.16,95.70%,65.12%respectively.⑨According to the ROC curve,serum CA125≤49.62mIU/ml determined tothe standard of success, and its sensitivity,specificity,false negative rate,false positiverate,Youden’s index, positive likelihood ratio,negative likelihood ratio, positive predictivevalue,negative predictive value was81.73%,71.88%,18.27%,28.12%,24.80%,2.91,0.25,90.43%,54.76%respectively.⑩The sensitivity and specificity of series testing results ofserum P and CA125levels was75.00%,100%respectively. The sensitivity and specificity ofparallel detection results of serum P and CA125levels was94.23%,64.71%respectively.Concluson①For the age levels of patients with threatened abortion whose outcomesare different, there is no obvious difference. The success rate of patients whose ages are below35years old is higher than the patients whose ages are great than or equal to35yearsold.②The history of spontaneous abortion and artificial abortion may couldn’t affecttreatment outcome of patients with threatened abortion.③For the patients who weregiven treatment,the serum P and HCG of successful patients are higher than thefailure patients, the serum CA125of successful patients are lower than the failure patients.④The patients whose serum P levels are great than or equal to12.23ng/ml,serum CA125levelsare less than or equal to49.62mIU/ml should be given trentment.The patients whose serum Plevels are lower than12.23ng/ml and serum CA125levels are higher than49.62mIU/mlshould be advised that the success rate of treatment is low, the rate of inevitable abortion ishigh.⑤The predictive value of serum P level is better than CA125level. The detection ofserum P and CA125levels should be connected in parallel. |
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