目的:探讨异位妊娠保守治疗前间隔48 h血β-h CG不同变化类型对甲氨蝶呤(MTX)不同用药方案的治疗效果。方法:回顾性分析异位妊娠保守治疗患者196例,根据治疗前间隔48 h血β-h CG水平的变化趋势分为上升型组和下降型组,再依据MTX全身用药方案分为单剂量亚组与多剂量亚组。比较血β-h CG水平不同变化类型下不同用药方案的治疗效果与药物副反应。结果:血β-h CG水平上升型组中,多剂量方案效果更好,治疗成功率更高,治疗后血β-h CG值恢复正常时间更快,与单剂量亚组比较差异有统计学意义(P<0.05);但单剂量亚组的药物副反应小与多剂量亚组,差异有统计学意义(P<0.05)。下降型组中,单剂量亚组的药物副反应亦小,与多剂量亚组比较有统计学差异(P<0.05);但治疗成功率及治疗后血β-h CG值恢复正常时间2个亚组间比较均无统计学差异(P>0.05)。结论:异位妊娠保守治疗前间隔48 h血β-h CG水平呈现上升型患者选择MTX多剂量方案,治疗效果更好。下降型患者选择MTX单剂量方案,药物副反应更小。 Objective: To investigate the therapeutic effect of different dosage regimen of methotrexate (MTX) on different dosage regimens of 48 h after conservative treatment of ectopic pregnancy. Methods: A total of 196 patients with conservative treatment of ectopic pregnancy were retrospectively analyzed. According to the change tendency of blood β-h CG level at 48 h before treatment, the patients were divided into ascending group and descending group. Group and multiple dose subgroups. The therapeutic effects and side effects of different drug regimens under different types of changes in blood β-h CG levels were compared. Results: In the elevated blood β-h CG group, the multi-dose regimen was better, the treatment success rate was higher, the blood β-h CG value returned to normal after treatment, and the difference was statistically significant compared with the single-dose subgroup (P <0.05). However, there was a significant difference between the single side dose subgroup and the multi dose side subgroup (P <0.05). In the descending type group, the side effects of single-dose subgroups were also smaller than those in the multi-dose subgroups (P <0.05), but the success rate of treatment and the return of the normal blood β-h CG value after treatment were 2 There was no significant difference between subgroups (P> 0.05). CONCLUSION: The level of serum β-h CG at 48 h after conservative treatment in ectopic pregnancy shows that the MTX multi-dose regimen is better than the traditional one. Decline patients choose MTX single dose program, drug side effects smaller.