Abstract：
Ectopic pregnancy is a life-threatening disease and is an important cause of pregnancy-related mortality. MTX is the primary conservative treatment medicine of ectopic pregnancy, and mifepristone is also a promising medicine. Through studying the ectopic cases at the third affiliated hospital of Sun Yat-Sen University, the study aims to analyze the indication and treatment outcome predictors of mifepristone.
The data of 269 ectopic pregnancy cases treated with mifepristone during the year 2011-2019 were retrospectively collected. Logistic-regression analysis was used to analyze the factors affiliated with the treatment outcome of mifepristone. Then ROC curve was used to analyze the indication and predictors.
Through logistic-regression analysis, HCG is the only factor related to the treatment outcome of mifepristone. The AUC of ROC curve predicting treatment outcome with pre-treatment HCG is 0.715, and the cutoff value of ROC curve is 372.66 (sensitivity 0.752, specificity 0.619). The AUC of 0/4 ratio predicting the treatment outcome is 0.886, and the cutoff value is 0.3283 (sensitivity 0.967, specificity 0.683). The AUC of 0/7 ratio is 0.947, and the cutoff value is 0.3609 (sensitivity 1, specificity 0.828).
Mifepristone can be used to treat ectopic pregnancy. HCG is the only factor related to the treatment outcome of mifepristone. Patients with HCG less than 372.66 U/L can be treated by mifepristone. If HCG descends more than 67.18% on the 4th day or 63.91% on the 7th day, it is more likely to have a successful treatment outcome. It is more precise to retest on the 7th day.
The data of 269 ectopic pregnancy cases treated with mifepristone during the year 2011-2019 were retrospectively collected. Logistic-regression analysis was used to analyze the factors affiliated with the treatment outcome of mifepristone. Then ROC curve was used to analyze the indication and predictors.
Through logistic-regression analysis, HCG is the only factor related to the treatment outcome of mifepristone. The AUC of ROC curve predicting treatment outcome with pre-treatment HCG is 0.715, and the cutoff value of ROC curve is 372.66 (sensitivity 0.752, specificity 0.619). The AUC of 0/4 ratio predicting the treatment outcome is 0.886, and the cutoff value is 0.3283 (sensitivity 0.967, specificity 0.683). The AUC of 0/7 ratio is 0.947, and the cutoff value is 0.3609 (sensitivity 1, specificity 0.828).
Mifepristone can be used to treat ectopic pregnancy. HCG is the only factor related to the treatment outcome of mifepristone. Patients with HCG less than 372.66 U/L can be treated by mifepristone. If HCG descends more than 67.18% on the 4th day or 63.91% on the 7th day, it is more likely to have a successful treatment outcome. It is more precise to retest on the 7th day.
摘要：
目的：异位妊娠是一种危及生命的疾病，是妊娠相关死亡的重要原因。MTX是异位妊娠的主要保守治疗药物，米非司酮也是一种很有前途的药物。通过对中山大学附属第三医院异位病例的研究,本研究旨在分析米非司酮的适应症和治疗结果预测因素。
方法：回顾性收集2011-2019年使用米非司酮治疗的269例异位妊娠病例资料。采用Logistic回归分析与米非司酮治疗效果相关的因素。然后用ROC曲线分析适应症和预测因子。
结果：通过逻辑回归分析，HCG是与米非司酮治疗结果相关的唯一因素。用治疗前HCG预测治疗结果的ROC曲线的AUC为0.715，ROC曲线的临界值为372.66（敏感性0.752，特异性0.619）。预测治疗结果的0/4比率的AUC为0.886，截止值为0.3283（敏感性0.967，特异性0.683）。0/7比值的AUC为0.947,截止值为0.3609(灵敏度1,特异性0.828)。
结论：米非司酮可用于治疗异位妊娠。HCG是与米非司酮治疗结果相关的唯一因素。HCG低于372.66U/L的患者可以使用米非司酮治疗。如果HCG在第4天下降超过67.18%或在第7天下降63.91%，它更有可能有一个成功的治疗结果。更精确的是在第七天重新测试。
方法：回顾性收集2011-2019年使用米非司酮治疗的269例异位妊娠病例资料。采用Logistic回归分析与米非司酮治疗效果相关的因素。然后用ROC曲线分析适应症和预测因子。
结果：通过逻辑回归分析，HCG是与米非司酮治疗结果相关的唯一因素。用治疗前HCG预测治疗结果的ROC曲线的AUC为0.715，ROC曲线的临界值为372.66（敏感性0.752，特异性0.619）。预测治疗结果的0/4比率的AUC为0.886，截止值为0.3283（敏感性0.967，特异性0.683）。0/7比值的AUC为0.947,截止值为0.3609(灵敏度1,特异性0.828)。
结论：米非司酮可用于治疗异位妊娠。HCG是与米非司酮治疗结果相关的唯一因素。HCG低于372.66U/L的患者可以使用米非司酮治疗。如果HCG在第4天下降超过67.18%或在第7天下降63.91%，它更有可能有一个成功的治疗结果。更精确的是在第七天重新测试。
