本文選題：凍胚移植術(shù)　切入點(diǎn)：胚胎天數(shù)　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的探討凍胚移植術(shù)后胚胎天數(shù)(embryonic day,ED)15-20時血清β-HCG值對妊娠結(jié)局的早期預(yù)測價值。方法回顧性分析在我院行凍胚移植的1600個周期,將妊娠結(jié)局分為三組:單胎活產(chǎn)組、雙胎活產(chǎn)組和非活產(chǎn)組。運(yùn)用t-檢驗分析不同妊娠結(jié)局間血清β-HCG值有無統(tǒng)計學(xué)差異,運(yùn)用受試者工作特性曲線(ROC)分析血清β-HCG值預(yù)測單胎活產(chǎn)與雙胎活產(chǎn)的界值。結(jié)果1.ED15-20,單胎活產(chǎn)組與雙胎活產(chǎn)組的血清β-HCG值均高于非活產(chǎn)組,差異有統(tǒng)計學(xué)意義(P0.001);雙胎活產(chǎn)組的血清β-HCG值均高于單胎活產(chǎn)組,差異有統(tǒng)計學(xué)意義(P0.001)。2.ED15時,將血清β-HCG界值定為174.5IU/L,具有最佳的單胎活產(chǎn)預(yù)測價值(敏感性:79.0%,特異性:84.6%,AUC:0.858);ED16 時,將血清 β-HCG界值定為216.5IU/L時,具有最佳的單胎活產(chǎn)預(yù)測價值(敏感性:84.7%,特異性:77.7%,AUC:0.881);ED17 時,將血清 β-HCG 界值定為 271.5IU/L 時,具有最佳的單胎活產(chǎn)預(yù)測價值(敏感性:86.9%,特異性:78.9%,曲線下面積:0.882);ED18時,將β-HCG界值定為426IU/L時,具有最佳的單胎活產(chǎn)預(yù)測價值(敏感性:86.1%,特異性:77.0%,AUC:0.907);ED19 時,將 β-HCG 界值定為 594IU/L時,具有最佳的單胎活產(chǎn)預(yù)測價值(敏感性:87.6%,特異性:83.3%,AUC:0.911);ED20時,將血清β-HCG界值定為872IU/L時,具有最佳的單胎活產(chǎn)預(yù)測價值(敏感性:83.5%,特異性:86.6%,AUC:0.888)。3.ED15時,將血清β-HCG界值定為401.0IU/L時,具有最佳的雙胎活產(chǎn)預(yù)測價值(敏感性:66.1%,特異性:71.4%,AUC:0.757);ED16時,將血清β-HCG界值定為603.5IU/L時,具有最佳的雙胎活產(chǎn)預(yù)測價值(敏感性:81.5%,特異性:70.2%,AUC:0.836);ED17 時,將血清 β-HCG 界值定為 842.5IU/L 時,具有最佳的雙胎活產(chǎn)預(yù)測價值(敏感性:77.6%,特異性:71.9%,AUC:0.818);ED18時,將β-HCG界值定為1251.0IU/L時,具有最佳的雙胎活產(chǎn)預(yù)測價值(敏感性:74.5%,特異性:64.2%,AUC:0.777);ED19時將血清β-HCG界值定為1876IU/L時,具有最佳的雙胎活產(chǎn)預(yù)測價值(敏感性:80%,特異性:69.5%,AUC:0.817);ED20時,將血清β-HCG界值定為3186.0IU/L時,具有最佳的雙胎活產(chǎn)預(yù)測價值(敏感性:82.6%,特異性:82.5%,AUC:0.894)。結(jié)論1.單胎活產(chǎn)組與雙胎活產(chǎn)組的ED15-20血清β-HCG值均大于非活產(chǎn)組,差異有統(tǒng)計學(xué)意義(P0.001),雙胎活產(chǎn)組的ED15-20血清β-HCG值均大于單胎活產(chǎn)組,差異有統(tǒng)計學(xué)意義(P0.001);2.ED19時,當(dāng)血清β-HCG界值定為594IU/L時,具有最佳的預(yù)測單胎活產(chǎn)的價值,敏感性為87.6%,特異性為83.3%,曲線下面積為0.911;3.ED20時,當(dāng)血清β-HCG界值定為3186IU/L時,具有最佳的預(yù)測雙胎活產(chǎn)的價值,敏感性為82.6%,特異性為82.5%,曲線下面積為0.894);4.凍胚移植術(shù)后可用ED15-20血清β-HCG值來預(yù)測單胎活產(chǎn)與雙胎活產(chǎn),但預(yù)測雙胎活產(chǎn)的準(zhǔn)確性低于單胎活產(chǎn).
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 孔娜;劉景瑜;王玢;孫海翔;;移植術(shù)后第14天血清β-HCG對輔助生育妊娠結(jié)局的預(yù)測[J];生殖醫(yī)學(xué)雜志;2015年09期

2 陳彩蓉;全松;王秋香;李艷紅;邱佩嫦;趙曉英;周林榮;郭海燕;;胚胎移植術(shù)后9和11d血清β-HCG值對妊娠結(jié)局的預(yù)測價值[J];南方醫(yī)科大學(xué)學(xué)報;2015年07期

3 徐蓓;朱桂金;章漢旺;艾繼輝;李豫峰;靳鐳;;胚胎移植術(shù)后14天妊娠患者血清β-HCG水平對妊娠結(jié)局的預(yù)測價值[J];中國實用婦科與產(chǎn)科雜志;2011年07期

，

本文編號：1649941