胰岛素样生长因子结合蛋白-1用于检测胎膜早破的临床意义

The Clinical Significance of Insulin-like Growth Factor Conjugated Proteins-1 Used for Testing Premature Rupture of Fetal Membranes

目的:探讨胰岛素样生长因子结合蛋白-1用于检测胎膜早破的临床意义,为今后临床诊治提供参考和借鉴。方法:本研究选取2012年5月-2013年11月本院确诊为胎膜早破的孕妇160例,根据孕妇的临床表现,将其胎膜情况分为三组,A组为胎膜已破组45例,B组为胎膜仍完整组55例,C组为怀疑胎膜已破组60例,对所有孕妇阴道分泌物进行胰岛素样生长因子结合蛋白-1(IGFBP-1)检测、pH试纸检测、阴道液涂片检测,对比分析三种检测方法的阴性预测值、阳性预测值、灵敏度、特异性。结果:IGFBP-1检测孕妇胎膜早破的阴性预测值为91.53%,阳性预测值为99.00%,灵敏度为95.24%,特异性为98.18%,明显高于pH试纸的63.33%、83.00%、79.05%、69.09%,也明显高于阴道液涂片的65.57%、84.85%、80.00%、72.73%,差异均有统计学意义(P<0.05)。结论:胰岛素样生长因子结合蛋白-1用于检测胎膜早破较pH试纸检测、阴道液涂片检测更具准确性及灵敏性,诊断胎膜早破可靠且安全,值得在临床实践中广泛的应用和推广。

Objective：To explore the clinical significance of insulin-like growth factor conjugated proteins-1 for testing premature rupture of fetal membranes and to provide a reference for future clinical diagnosis and treatment. Method：160 pregnant women who were diagnosed with premature rupture of membranes were selected from May 2012 to November 2013 in our hospital. According to the clinical manifestation of pregnant women,their membranes conditions were divided into three groups. Group A included 45 ruptured fetal membranes cases. Group B included 55 intact fetal membranes cases. Group C included 60 suspected ruptured membranes cases. The vaginal fluid of all pregnant women were given insulin-like growth factor binding protein-1（IGFBP-1）test,pH test paper test and vaginal fluid smear test. Then the negative predictive value, positive predictive value,sensitivity and specificity of the three detection methods were compared and analyzed. Result：The negative predictive value,positive predictive value,sensitivity and specificity of IGFBP-1 in the detection of pregnant women with premature rupture of membranes were 91.53%,99.00%,95.24%and 98.18%,which were significantly higher than those of the pH test paper i.e. 63.33%,83.00%,79.05%and 69.09%as well as those of the vaginal fluid smear i.e. 65.57%,84.85%,80.00%and 72.73%. The differences were statistically significant. Conclusion：When testing premature rupture of fetal membranes,insulin-like growth factor conjugated proteins-1 test is more accuracy and sensitivity than pH paper test and vaginal fluid smear test. Its diagnosis of premature rupture of fetal membranes is reliable and safe. It is worthy to be applied and promoted widely in clinical practices.