Abstract：
OBJECTIVE: The objective of the study was to increase the prediction of success of single-dose methotrexate therapy in ectopic pregnancy patients with modified parameters obtained from complete blood count and beta-human chorionic gonadotropin (β-hCG) parameters. In this way, it was aimed to predict patients whose methotrexate treatment may fail and rupture, to avoid unnecessary methotrexate treatment, to shorten the duration of hospital stay and to reduce patient mortality.
METHODS: 233 patients diagnosed with ectopic pregnancy between January 1, 2017, and March 01, 2022, in the obstetrics and gynecology service of a tertiary center were included in the study.
RESULTS: The mean of β-hCG was 1976 in the methotrexate group and 2358 in the surgery group (p < 0.05). The ROC curve determined the effect of BW (β-hCGxWBC/1000) and BP (β-hCGx1000/PLT) markers in diagnosing patients who will need surgery in ectopic pregnancy. The areas under the ROC curve for β-hCG, BW and BP were 0.86, 0.99 and 0.94, respectively (p < 0.05). β-hCG > 2139.03, BW > 30.96 and BP > 10.17 values were significantly associated with the need for surgery in ectopic pregnancy patients (p < 0.05). Logistic regression analysis revealed that a 1-unit increase in BP caused a statistically significant 1.77-fold increase in surgical need in patients with ectopic pregnancy. In contrast, a 1-unit increase in BW caused a 2.34-fold increase in surgical need (p < 0.05).
CONCLUSIONS: The study results showed that BW and BP values together with β-hCG are effective in predicting ectopic pregnancy patients who may undergo surgery.
METHODS: 233 patients diagnosed with ectopic pregnancy between January 1, 2017, and March 01, 2022, in the obstetrics and gynecology service of a tertiary center were included in the study.
RESULTS: The mean of β-hCG was 1976 in the methotrexate group and 2358 in the surgery group (p < 0.05). The ROC curve determined the effect of BW (β-hCGxWBC/1000) and BP (β-hCGx1000/PLT) markers in diagnosing patients who will need surgery in ectopic pregnancy. The areas under the ROC curve for β-hCG, BW and BP were 0.86, 0.99 and 0.94, respectively (p < 0.05). β-hCG > 2139.03, BW > 30.96 and BP > 10.17 values were significantly associated with the need for surgery in ectopic pregnancy patients (p < 0.05). Logistic regression analysis revealed that a 1-unit increase in BP caused a statistically significant 1.77-fold increase in surgical need in patients with ectopic pregnancy. In contrast, a 1-unit increase in BW caused a 2.34-fold increase in surgical need (p < 0.05).
CONCLUSIONS: The study results showed that BW and BP values together with β-hCG are effective in predicting ectopic pregnancy patients who may undergo surgery.
摘要：
目的：本研究的目的是提高对全血细胞计数和β-人绒毛膜促性腺激素（β-hCG）参数改良的异位妊娠患者单剂量甲氨蝶呤治疗成功的预测。这样,旨在预测甲氨蝶呤治疗可能失败和破裂的患者，为了避免不必要的甲氨蝶呤治疗，缩短住院时间并降低患者死亡率。
方法：在2017年1月1日至2022年3月1日期间在三级中心的妇产科服务中诊断为异位妊娠的233例患者被纳入研究。
结果：甲氨蝶呤组的β-hCG平均值为1976，手术组为2358（p<0.05）。ROC曲线确定了BW（β-hCGxWBC/1000）和BP（β-hCGx1000/PLT）标志物在诊断异位妊娠需要手术的患者中的作用。β-hCG的ROC曲线下面积,BW和BP分别为0.86、0.99和0.94(p<0.05)。β-hCG>2139.03，BW>30.96和BP>10.17值与异位妊娠患者的手术需求显着相关（p<0.05）。Logistic回归分析显示，血压增加1个单位会导致异位妊娠患者的手术需求增加1.77倍。相比之下,BW增加1个单位导致手术需求增加2.34倍(p<0.05)。
结论：研究结果表明，BW和BP值以及β-hCG可以有效预测可能接受手术的异位妊娠患者。
方法：在2017年1月1日至2022年3月1日期间在三级中心的妇产科服务中诊断为异位妊娠的233例患者被纳入研究。
结果：甲氨蝶呤组的β-hCG平均值为1976，手术组为2358（p<0.05）。ROC曲线确定了BW（β-hCGxWBC/1000）和BP（β-hCGx1000/PLT）标志物在诊断异位妊娠需要手术的患者中的作用。β-hCG的ROC曲线下面积,BW和BP分别为0.86、0.99和0.94(p<0.05)。β-hCG>2139.03，BW>30.96和BP>10.17值与异位妊娠患者的手术需求显着相关（p<0.05）。Logistic回归分析显示，血压增加1个单位会导致异位妊娠患者的手术需求增加1.77倍。相比之下,BW增加1个单位导致手术需求增加2.34倍(p<0.05)。
结论：研究结果表明，BW和BP值以及β-hCG可以有效预测可能接受手术的异位妊娠患者。
