宫颈长度联合高磷酸化胰岛素样生长因子结合蛋白-1预测早产的价值

Cervical length and high phosphorylated insulin-like growth factor binding protein-1 in the prediction of preterm delivery

目的探讨超声检查宫颈长度联合检测早产孕妇宫颈分泌物中高磷酸化胰岛素样生长因子结合蛋白-1(phIGFBP-1)对预测早产的价值。方法选取我院2011年1月至2012年12月,孕28～36周孕妇106例。采用分娩预测试剂盒检测孕妇宫颈分泌物中phIGFBP-1,并联合B超测量计算宫颈指数。按照分娩情况分为早产组和足月组,对数据进行记录并作出比较与分析。结果 106例孕妇妊娠分娩结果为早产组24例,足月组82例;测量平均宫颈长度,早产组为(3.51±0.59)cm,足月组为(4.21±0.89)cm。将宫颈长度≤4.0cm作为指标和临界点,在phIGFBP-1的阳性率中早产组占50%(13/26),足月分娩组占50%(13/26)。二者联合预测的结果为早产敏感性为54.2%;早产特异度值为100%;阳性预测值为100%;阴性预测值为85.7%。结论以孕妇宫颈分泌物中phIGFBP-1检测为阳性且检查宫颈长度≤4.0cm为指标可以提高早产预测的准确性。

Objective To investigate the value of detection of cervical length combined with high phosphory- lated insulin-like growth factor binding protein-I （phlGFBP-1） in cervical secretions for predicting preterm delivery. Methods One hundred and six pregnant women with 28-36 weeks of pregnancy in our hospital from January 2011 to December 2012 were enrolled in the study. Delivery prediction kits were applied to detect phIGFBP-1 in cervical secretions of pregnant women, and B ultrasound was used to measure cervical index. After delivery, the women were divided into preterm group and full-term group, and the clinical data was recorded and compared. Results The pre- term group had 24 cases, and the full-term group included 82 cases. The cervical length was （3.51±0.59） cm in the pre- term group and （4.21±0.89） cm in the full-term group. Taking cervical length ≤4.0 cm as the indicator and the critical point, the phIGFBP-1 positive rate was 50% （13/26） in the preterm group and 50% （13/26） in the full-term group. For combined prediction by the two methods, the sensitivity was 54.2% and the specificity was 100%, with the positive predictive value of 100% and the negative predictive value of 85.7%. Conclusion Taking positive detection of phlGFBP-1 in cervical secretions of pregnant women and cervical length ≤ 4.0 cm as indicators can improve preterm prediction.