【摘要】：目的探討血清β-h CG變化百分比在甲氨蝶呤(MTX)治療異位妊娠(EP)療效評價中的價值。方法選取EP患者138例,采用單獨MTX肌內(nèi)注射(50 mg/m2)治療,根據(jù)公式計算每例患者血清β-h CG在MTX治療1、4、7 d后的變化百分比。結(jié)果 MTX治療4 d后血清β-h CG的中位值下降達55.8%的病例中89.6%治療有效。MTX治療EP成功105例(76.3%,成功組),失敗33例(23.7%,失敗組)。成功組中血清β-h CG變化百分比在治療1、4、7d后下降的例數(shù)占治療成功人數(shù)的比例分別為54.3%、63.4%、85.1%。ROC曲線分析結(jié)果顯示,治療1 d后血清β-h CG變化百分比的ROC曲線下面積是0.63(95%CI為0.49~0.76;P0.05),敏感度為52.9%,特異度為65.0%,陽性預(yù)測值(PPV)為45.6%,陰性預(yù)測值(NPV)為55.2%。治療4 d后血清β-h CG變化百分比的ROC曲線下面積為0.69(95%CI為0.58~0.82;P0.05),敏感度為61.8%,特異度為70.0%,PPV為47.6%,NPV為53.1%。治療7 d后血清β-h CG變化百分比ROC曲線下面積為0.79(95%CI為0.68~0.91;P0.05),敏感度為83.8%,特異度為60.0%,PPV為58.9%,NPV為41.7%。結(jié)論治療4 d后的血清β-h CG變化百分比可預(yù)測MTX治療EP的療效及判斷EP患者對MTX單劑量治療的敏感性。
[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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