摘要
目的探讨宫颈阴道分泌物中胰岛素样生长因子结合蛋白-1(IGFBP-1)检测胎膜早破及预测早产的临床价值。方法选择2011年9月至2012年3月在中国医科大学附属盛京医院住院并临床确诊的胎膜早破孕妇87例,临床确诊无胎膜早破孕妇88例,临床疑似胎膜早破孕妇25例,对宫颈分泌物分别进行IGFBP-1(胶体金法)检测及pH检测,并对其预测早产情况进行研究。结果 IGFBP-1(胶体金法)检测胎膜早破的灵敏度98.85%(86/87),特异度98.86%(87/88),阳性预测值98.85%,阴性预测值98.86%,优于目前临床上应用最多的pH试纸法[灵敏度68.97%(60/87)]。患者发生胎膜早破时,IGFBP-1(胶体金法)预测72h早产发生的阳性预测值为97.44%,而未发生胎膜早破,其阳性预测值仅为6.67%。疑似胎膜早破组的25例中,IGFBP-1(胶体金法)阳性有16例,72h内临床确诊胎膜早破或分娩的有13例(包括3例死产),其中早产9例,早产的阳性预测值为56.25%。结论阴道分泌物中检测IGFBP-1(胶体金法)可作为快速检测胎膜早破的有效方法,同样也可用于预测早产的发生。
Objective The aim of this study was to determine the role of insulin-like growth factor binding protein-1（IGFBP-1） in the cervical-vaginal secretion in the diagnosis of premature rupture of membranes and prediction of preterm delivery.Methods Based on the clinical diagnosis,patients were grouped as clinically confirmed premature rupture of membranes（PROM,n=87）,clinically suspected PROM（n=25） and women with intact fetal membranes（n=88）.Detection of IGFBP-1 in the cervical-vaginal secretions and pH paper was done in all the cases.Results For the IGFBP-1 test（colloidal gold method）,the sensitivity was 98.85%（86/87 in clinically confirmed PROM）,the specificity was 98.86%（87/88 with intact membranes）,the positive predictive value was 98.85%,and the negative predictive value was 98.86%.It＇s better than pH paper.Among women with PROM,the negative predictive value was 97.44%,which was used to predict the preterm delivery in the next 72 hours.However,the negative predictive value was only 6.67% for women without PROM.Among 25 women with clinically suspected PROM,16（64%） tested positive for IGFBP-1.In this group,there were 13 cases which were diagnosed premature rupture of membranes or giving delivery within 72 hours,which included 3 stillbirths.Among the 13 cases,9 cases were preterm delivery.The positive predictive value of preterm delivery is 56.25%.Conclusion The screening test of IGFBP-1 in the cervical-vaginal secretions is effective to detect PROM,which is helpful for the early diagnosis of premature rupture of membranes.It is also helpful to predict preterm delivery.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2012年第11期865-867,共3页
Chinese Journal of Practical Gynecology and Obstetrics
基金
中华国际医学交流基金会基金(CIMF-F-007)
关键词
胰岛素样生长因子结合蛋白-1
胎膜早破
早产
insulin-like growth factor binding protein-1（IGFBP-1）
premature rupture of memberane（PROM）
preterm delivery
