摘要
目的观察胎儿纤维连结蛋白（fetal fibronentin，fFN）对先兆早产孕妇发生早产的预测价值，联合宫颈长度测量是否提高对早产的预测。方法采用ADEZA公司fFN快速检测试条测定50例先兆早产孕妇阴道后穹窿分泌物中fFN水平及宫颈长度的超声测量，追踪其妊娠结局。结果（1）50例先兆早产孕妇，fFN阳性19例，阳性率38％，16例发生早产，占84．2％，与fFN阴性组比较，差异有统计学意义；〈7d、14d、〉14d分娩的阴性预测值分别为100％、100％、87．1％。（2）50例先兆早产孕妇同时测量宫颈长度，以宫颈长度≤30mm为异常，fFN阳性和宫颈长度异常者与fFN阳性而宫颈长度正常组比较，P〉0．05，差异无统计学意义。二者同时异常预测早产发生的敏感性、特异性、阳性预测值、阴性预测值分别为70％、93．5％、93．3％、82．9％。结论fFN是预测早产的客观指标，阴性预测值意义更大。联合宫颈长度测量可提高对早产的阳性预测值。
Objective To determine the predictive value of fetal fibronectin（fFN） for preterm birth in pregnancy women with threatened preterm birth and whether the predictive value could be improved when fFN combined with cervical length （CL）. Methods fFN level in discharges from the posterior fornix were detected using a rapid detection test paper of ADEIA company and the CL were measured by vaginal ultrasound scan for all 50 pregnancy women with threatened preterm birth. Pregnant outcomes were recorded. Results （ 1 ） Among 50 subjects, positive fFN was detected in 38% （ 19 cases）. The incidence of preterm birth was 84. 2% （16/19）, the difference was significant compared to the group with negative fFN. The negative predictive value（NPV） of delivery within 7 days,14 days and 〉 14 days were 100% ,100% and 87. 1%. （2） CL was measured in all 50 cases,the CL≤30 mm was abnormal. The rate of preterm birth in the group of both positive fFN and abnormal CL was not significantly higher than the group of positive fFN and normal CL. The sensitivity, specificity, positive predictive value （PPV） and NPV of abnormal CL and positive fFN for preterm birth were 70% ,93.5% ,93. 3% and 82. 9%. Conclusions Vaginal fFN is an objective indicator for predicting preterm labor,especially significant for NPV. Vaginal fFN dermination combined with CL measurement can improve the PPV of preterm delivery.
出处
《浙江临床医学》
2010年第5期453-455,共3页
Zhejiang Clinical Medical Journal
