协和医学杂志

2015, v.6(03) 212-215

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持续性真性低水平人绒毛膜促性腺激素升高6例临床特点
Clinical Characteristics of Six Patients with Persistent Real Low-level Elevation of Human Chorionic Gonadotropin

吕嬿;冯凤芝;向阳;万希润;
Lü Yan;FENG Feng-zhi;XIANG Yang;WAN Xi-run;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

目的探讨持续性真性低水平人绒毛膜促性腺激素(human chorionic gonadotropin,h CG)升高患者的临床特点和诊治意义。方法 2011年8月至2015年3月北京协和医院诊断为持续性真性低水平h CG升高患者6例,收集患者临床资料,对疾病特点、诊治过程和随诊情况进行回顾性分析。结果 6例患者中,3例继发于葡萄胎清宫术后,3例继发于侵蚀性葡萄胎化疗后。3例侵蚀性葡萄胎患者的中位总疗程数为8个,均有化疗失败史。6例患者随诊中位时间为24个月,自治疗结束至h CG呈低水平升高的中位时间为5.5个月,低水平h CG升高持续的中位时间为16.5个月。4例患者病情稳定,1例进展为绒毛膜癌,1例自然妊娠分娩后h CG降至正常。结论持续性真性低水平h CG升高的持续时间较长,对化疗不敏感,应密切随诊,不宜治疗。
Objective To investigate the clinical characteristics and significance of diagnosis and treatment associated with persistent real low-level elevation of human chorionic gonadotropin( h CG). Methods Six patients diagnosed with persistent real low-level h CG elevation at Peking Union Medical College Hospital in the period from August 2011 to March 2015 were collected. Clinical records of the 6 patients were reviewed to retrospectively analyze clinical features,diagnosis and treatment approaches,and follow-up results. Results Among the 6 patients,3 were secondary to uterine curettage for hydatidiform moles,and the other 3 had received chemotherapy for invasive moles,in whom the median chemotherapy cycle number was 8 and all experienced failure of at least one chemotherapy regimen. The median follow-up time was 24 months. The median period between the termination of treatment and the initial low-level h CG elevation was 5. 5 months. The median duration of low-level h CG elevation was 16. 5 months. Four patients had no evidence of progression,1 patient progressed to choriocarcinoma,and 1 presented with the h CG level decreasing to the normal range after spontaneous delivery. Conclusion Persistent real low-level h CG elevation may persist for a long time and not respond to chemotherapy. Longterm close monitoring is necessary,but treatment is not recommended.

关键词(KeyWords): 人绒毛膜促性腺激素;妊娠滋养细胞疾病;化疗
human chorionic gonadotropin;gestational trophoblastic disease;chemotherapy

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作者(Author): 吕嬿;冯凤芝;向阳;万希润;
Lü Yan;FENG Feng-zhi;XIANG Yang;WAN Xi-run;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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