检测阴道液HCG及AFP水平诊断胎膜早破的临床价值

Diagnosis of Premature Rupture of Membranes by the Identificatian of HCG and AFP in Vaginal Fluid

目的:探讨阴道液人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)、甲胎蛋白(alpha-fetoprotein,AFP)水平在诊断胎膜早破中的临床价值。方法:①采用北京蓝十字生物技术有限公司生产的胶体金早早孕检测试纸对HCG定性检测。②应用放射免疫法(radioimmu noassay,RIA)对30例胎膜早破和20例胎膜未破的正常孕妇阴道液进行HCG、AFP定量测定。结果:①早孕试纸诊断的敏感性为93.3%,特异性为100%。②胎膜早破组阴道液β-HCG、AFP测量中位数值分别为820.00 mIu/ml和212.90 ng/ml,明显高于对照组的5.55 mIu/ml和0.12 ng/ml(P<0.01);四分位数间距分别为557.40 mIu/ml和199.50ng/ml,明显高于对照组的3.87 mIu/ml和0.30 ng/ml(P<0.01);以β-HCG≥50 mIu/ml或AFP≥30 ng/ml为阳性参考值,阳性检出率均为93.3%;其诊断的敏感性均为93.3%;特异性均为100%。③3种检测胎膜早破的方法无显著性差异。结论:阴道液HCG定性、定量检测和AFP定量检测,尤其是早早孕试纸检测是胎膜早破简易、准确、快速的诊断方法。

Objective：To study the clinical value of vaginal fluid β- HCG and AFP detecting in diagnosis of premature rupture of membranes （PROM）. Methods ： （1）Collooidal gold assay was used to detect HCG in the fluid of vaginal. （2）Vaginal fluid β - HCG and AFP were measured by radioimmn noassay following burn injury in 30 cases with PROM and 20 cases of normal pregnant women, respectively. Results： （1）The positives of early pregnancy test were 93.3 %, the specificities were 100 %. （2）The medians of β- HCG and AFP in vaginal fluid of PROM were 820.00 mIu/ml and 212.90 ng/ml, respectively. These values were significantly higher than those （5.55 mIu/ml and 0.12 ng/ml） of the normal pregnant women （P 〈 0.01）, The quartiles of β - HCG and AFP in vaginal fluid of PROM were 557.40 mIu/ml and 199.50 ng/ml, respectively. These values were significantly higher than those（3.87 mIu/ml and 0.30 ng/ml） of the normal pregnant women（P 〈 0.01 ）. Using a threshold value of β - HCG 50 mIu/ml or AFP 30 ng/ml for the diagnosis of PROM, the positives were 93.3 % and 93.3 %, the sensitivities were 93.3 % and 93.3 %, the specificities were 100 % and 100 %, respectively. （3）Three method had no difference. Conclusion ：Detection of vaginal fluid β- HCG and AFP, especially early pregnancy test is useful for the accurate and quick diagnosis of premature rupture of membranes.