检测宫颈分泌物中的胎盘α1微球蛋白诊断胎膜早破的价值

Value of detecting placenta microglobulin α1 in cervical secretion to diagnose premature rupture of membranes

目的通过建立和验证胎盘α1微球蛋白含量检测试纸条法诊断胎膜早破(PROM)的方法,提高PROM临床诊断的灵敏性和特异性。方法将研究对象分为3组:确诊破水组(n=40)、确诊未破水组(n=40)、可疑破水组(n=120)。本次研究将采用临床上常规使用的两种胎膜破裂检测方法(硝嗪试纸法、积液法)作为对照组,当结果可疑时行羊膜镜检查;胎盘α1微球蛋白含量检测作为研究组。并将两者结果进行对比,从统计学方面判定研究组与对照组的诊断价值差别。结果检测胎盘α1微球蛋白诊断PROM的敏感性、特异性、阳性预测值分别为98%、100%、100%,硝嗪试纸法和(或)积液法的敏感性为85%,特异性为75%,阳性预测值均为80%。检测胎盘α1微球蛋白诊断PROM的敏感性、特异性、阳性预测值均显著高于硝嗪试纸法和(或)积液法。结论检测宫颈分泌物中的胎盘α1微球蛋白诊断胎膜早破有较高价值,该方法指示PROM发生的准确率接近100%。检测胎盘α1微球蛋白诊断PROM的准确性高,操作简便。

Objective To increase the sensitivity and specificity of placenta microglobulin α1 for diagnosing premature rupture of membranes（PROM） by establishing and verifying the detection strip method. Methods The stdy subjects were divided into 3 groups, the rupture of membrane group（n=40）, the unrupture of membrane group （n= 40） and the suspicious rupture of mem- brane group（n= 120）. Two kinds of detection method （ nitrazine paper test and effusion method） routinely used in clinic were as the control group. When the results were suspicious, the amnioscopy was adopted. The detection of placenta microglobulinα1 was used as the study group. The detection resuls were compared between the two groups and the difference of diagnostic value was statistically judged between the study group and the control group. Results The sensitivity,specificity and positive prediction value for diagnosing PROM were 98%, 100% and 100% in the detection of placenta microglobulin α1, and 85%, 75% and 80% in the nitrazine paper test and the effusion method. The sensitivity, specificity and positive prediction value in the detecting placenta micro- globulin α1 for diagnosing PROM all were higher than those in the two conventional methods. Conclusion Detecting placenta mi- eroglobulin α1 in cervical secretion to diagnose PROM has higher value, in which, the accuracy indicating PROM occurrence ap- proaches to 100%. Using this method to diagnose PROM has high accuracy with simple operating.