甲氨蝶呤对异位妊娠血清人绒毛膜促性腺激素高值患者的疗效及安全性

Efficacy and safety of methotrexate in treatment of patients with high serum human chorionic gonadotropin in ectopic pregnancy

摘要:

目的 探讨甲氨蝶呤在不同血清人绒毛膜促性腺激素（β-hCG）水平的异位妊娠患者中的疗效和安全性。方法 选取2019年1月—2020年10月海南现代妇女儿童医院收治的90例异位妊娠患者为研究对象。根据治疗前24 h的β-hCG水平将患者分为β-hCG高值组55例（β-hCG ≥3 000 u/L）和β-hCG低值组35例（β-hCG <3 000 u/L）。所有患者给予甲氨蝶呤50 mg/m²肌内注射。比较两组治疗后的临床疗效、β-hCG水平恢复情况、异位妊娠包块消失情况及不良反应。结果 治疗7 d后β-hCG高值组临床总有效率高于β-hCG低值组（P <0.05）；治疗7 d后β-hCG高值组β-hCG恢复时间短于β-hCG低值组（P <0.05），β-hCG水平低于β-hCG低值组（P <0.05），异位妊娠包块消失时间短于β-hCG低值组（P <0.05），异位妊娠包块直径小于β-hCG低值组（P <0.05）；两组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 相对于低值β-hCG患者，高值β-hCG异位妊娠患者接受甲氨蝶呤治疗后的临床疗效及安全性更好。

Abstract:

Objective To observe the effect and safety of methotrexate in patients with ectopic pregnancy with different serum human chorionic gonadotropin (β-hCG) trends.Methods Ninty patients with ectopic pregnancy were selected from January 2019 to October 2020 in Hainan Modern Women and Children's Hospital and divided into the β-hCG high value group (β-hCG ≥ 3 000 u/L, 55 cases) and the β-hCG low value group (β-hCG < 3 000 u/L, 35 cases) according to the changes of β-hCG 24h before treatment. All patients were given methotrexate 50 mg/m2 intramuscularly. The treatment effect, β-hCG recovery, disappearance of ectopic pregnancy masses, progesterone, estrogen, and adverse reactions were observed.Results The total clinical effective rate in the β-hCG high value group was higher than that in the β-hCG low value group, and the difference was statistically significant (P < 0.05). The recovery time of β-hCG and the disappearance time of ectopic pregnancy mass in the β-hCG high value group were shorter than those in the β-hCG low value group, after 7 days of treatment, the diameters of β-hCG and ectopic pregnancy mass were lower than those in the β-hCG low value group, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of total adverse reactions between the two groups (P > 0.05).Conclusion Compared to low value β- HCG patients, the clinical effect of ectopic pregnancy patients with high β-hCG was better after receiving methotrexate treatment.