目的探讨血清 β-人绒毛 膜促性腺激素(β-hCG)在人类辅助生育(ART)所获妊娠中能否精确预测妊娠成功与否的价值 。方法对1998年12月至2 000年2月我院所 行的49个成功周期的体外受精-胚胎移植(IVF-ET)进行回顾性分析，46例均在胚胎移 植后第14天抽血检测β-hCG浓度，进行统计分析。结 果 46个成功周期可行妊娠率为78.3%(36/46)。可行妊娠 组与非可 行妊娠组β-hCG ±s分别为(472± 45)U/L、(89±24)U/L，P＜0.05。以β-hCG浓度1 00 U/L作为划分可行 妊娠 与非可行妊娠的判断限值，敏感性97%，特异性80%，其阳性预测值为95%，阴性预测 值为89%。在46例中有10例为多胎妊娠，其β-hCG为(656±70) U/L，显著区 别于单胎 妊娠［β-hCG(288±20)U/L］。可行妊娠率随β-hCG的升高而增加，多胎的概率也 随之增加。结论血清β-hCG检测在人类辅助生育所获妊 娠中是一个极好的早期预测手段，有利于帮助患者夫妇减少顾虑，多胎的预测更有助于医生 及时了解情况，采取必要的措施。%Objective To study whether a single s erum β-hCG determination in pregnancies ach ieved by assist ed reproductive technologies(ART) can accurately predict pregna ncy viability and inviable pregnancies, multiple gestation. Method Fo urty-nine consecutive succe ssful ART pregnancies between November 1998 and February 2000 were studied retrospectively. Fourty-six subjects had a serum β-hCG determinetion 14 day s after ET were analyzed. Results 36 of the 46(78.3%) were found to be viable. The mean β-hCG value of the nonviable was(89±24) U/L, the viable was(472±45)U/L，statistically significant differences were fou nd between thes e two groups, P＜0.05. According to the cut off v alue of a single β-hCG＞100 U/L in distinguishing viable from nonviable pregnancies achieved, the sensitivity was 97%, specificity 80%,the positive predictive value 95%,the negative p redictive value 89%. Ten of the 46 were multiple gestations, the mean β-hCG o f the multiple ge stations ［(656±70) U/L］ was significantly different from that o f the singleton pregnancies ［(288±20)U/L］.The probability of viable, and fu rthermore multiple p regnancies increase when the value of β-hCG goes up. Conclusion A single early serum β-hCG determinaton 14 alays after ET is clinically valuab le in predicting p regnancy outcome achieved by ART. It will help the gynecologists to take some m easurements in timely. Early reassuring tests may reduce an xiety of the couple.
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