摘要
目的探讨常用巨大儿预测公式的临床价值,寻找预测巨大儿的最佳方法。方法回顾性分析121例巨大胎儿的临床病案,选择同期体重正常胎儿102例作为对照组。用统计学方法计算7种公式的敏感度,特异度,阳性预测值,阴性预测值和约登指数,用以分析较好的预测指标。结果宫高法敏感度24%,特异度99%,阳性预测值96.7%,阴性预测值52.3%,约登指数0.21。宫高加腹围联合法敏感度59.5%,特异度78.4%,阳性预测值76.6%,阴性预测值62%,约登指数0.38。双顶径≥9.5cm法敏感度69.4%,特异度77.5%,阳性预测值78.5%,阴性预测值68.1%,约登指数0.47。双顶径加股骨长≥16.5 cm法敏感度84.3%,特异度48%,阳性预测值65.8%,阴性预测值72.1%,约登指数0.32。股骨长≥7.5 cm法敏感度19%,特异度94.1%,阳性预测值79.3%,阴性预测值49.5%,约登指数0.13。胎儿腹围≥35 cm法敏感度53.7%,特异度87.3%,阳性预测值83.3%,阴性预测值61.4%,约登指数0.41。胎儿腹围加股骨长≥42.5 cm法敏感度44.6%,特异度91.2%,阳性预测值85.7%,阴性预测值58.1%,约登指数0.36。结论双顶径≥9.5 cm法和胎儿腹围≥35 cm法是较好的预测指标,单纯公式预测均有局限性,应综合评估。
Aim To explore the clinical values of seven predictive methods for macrosomia and to find the best of them. Methods Retrospectively, 121 pregnant wemen with fetal macrosomia were enrolled in this study and 102 pregnant wemen with normal neonatal birthweight were radomly chosen as a control group. The sensitivity, specificity, positive predictive value （ PPV ）, nagative predictive value （NPV） and Youden＇s index of them were calculated by statistical method to analyze the better of them. Results The measure using the uterus fundal height at the cut-off leval of 40 cm showed a sensitivity of 24% ,with a specificity of 99% ,a PPV of 96.7% ,a NPV of 52. 3% and a Youden＇s index of 0.21. The measure using the sum of uterus fundal height and maternal abdominal circumference（AC） showed a sensitivity of 59.5% at the cut-off level of 140 em with a specificity of 78.4% , a PPV of 76.6%, a NPV of 62% and a Youden＇s index of 0.38. The measure using the fetal biparietal diameter（BPD） at the cut-off leval of 9.5 cm showed a sensitivity of 69.4% ,with a speeificity of 77.5% ,a PPV of 78.5% ,a NPV of 68.1% and a Youden＇s index of 0.47. The measure using the femur length（FL） showed a sensitivity of 19% at the eut-off level of 7.5 cm with a specificity of 94.1% ,a PPV of 79.3% ,a NPV of 49.5% and a Youden＇s index of 0.13. The measure using the fetal AC showed a sensitivity of 53.7% at the cut-off level of 35 em with a speeifieity of 87.3%, a PPV of 83.3% , a NPV of 61.4% and a Youden＇s index of 0.41. The measure using the sum of BPD and FL showed a sensitivity of 84.3 % at the cut-off level of 16.5 cm with a specificity of 48%, a PPV of 65.8%, a NPV of 72.1% and a Youden＇s index of 0.32. The measure using the sum of fetal AC and FL showed a sensitivity of 44.6% at the cut-off level of 42.5 cm with a specificity of 91.2%, a PPV of 85.7%, a NPV of 58.1% and a Youden＇s index of 0.36. Conclusion Methods of BPD ≥ 9.5 cm and fetal AC ≥35 cm are better than others. There are limitations with sole formula prediction,so comprehensive assessment should be made.
出处
《安徽医药》
CAS
2008年第12期1178-1179,共2页
Anhui Medical and Pharmaceutical Journal
