The Study On The Dynamic Variation Of HCG In Blood After Conservative Treatment Of Ectopic Pregnancy

Objective: To investigate the correlation between the changes of blood HCG levels and the final prognosis of patients after treatment at 1d,4d and 7d after conservative treatment of ectopic pregnancy.Methods: A total of 111 clinical cases of ectopic pregnancy patients who were diagnosed and treated with methotrexate combined with mifepristone tablets were analyzed retrospectively from October 2014 to October 2016 at the Affiliated Hospital of Qinghai University.According to the final outcome of the conservative treatment,the patients were divided into 94 groups: the successful group and the failure group(n = 17).The changes of blood HCG values before and during the course of drug conservative treatment,the course of medications used and the occurrence of apparent side effects were observed between the two groups.Results:The success rate of the drug conservative treatment was 84.68%.Two groups of patients the levels of HCG in the initial blood and after the treatment of 1d,4d,7d blood HCG levels in the successful group were lower than the failure group.The effective rate of conservative treatment for patients with different stratified levels of HCG was different.After the drug treatment of 1d blood HCG value decreased to predict the final success of the treatment of sensitivity and specificity were 94.7% and94.1%,and Youden index was 0.888,the area under ROC curve was 0.967;After treatment the 4d blood HCG value sensitivity decline success in predicting final efficacy and specificity were 84.0% and 100.0%,and Youden index was 0.840,the area under ROC curve was 0.956;After the treatment of 7d blood HCG value decreased sensitivity on the final prediction of the efficacy of patients with success was 90.4% and specificity was 94.1%,Youden index was 0.845 and the area under the ROC curve was 0.956.Conclusions: The HCG value of EP in serum before and after treatment at 1d,4d and7 d were predictive of the final outcome of conservative treatment.The HCG values of 1d,4d and 7d decreased after drug conservative treatment(compared with the initial blood HCG value),which were predictive of the final outcome.The decrease of HCG value of 1d after conservative treatment predicted conservative treatment was better than that of 4d and 7d.After treatment,the decrease in the level of HCG in the first day can be used as a clinical treatment of patients with conservative treatment of early success or not,is not suitable as a patient's discharge indication;It is feasible to evaluate whether the patient can be discharged from hospital or continue to be treated with second courses of treatment after the treatment of 7th day.There was no difference between the two groups of patients after conservative treatment in the side effects and the course of treatment.