phIGFBP-1与宫颈长度对早产的预测

Diagnostic value for predicting premature delivery by phIGFBP-1 and cervical length

目的探究高磷酸化胰岛素样生长因子结合蛋白-1(phIGFBP-1)与宫颈长度对早产预测价值。方法选取2013年6月至2014年12月在湖州师范学院附属第一医院妇产科收治的96例孕周为28~37周早产高危孕妇,按照妊娠结局分为早产组(32例),足月产组(64例)。对两组研究对象宫颈黏液phIGFBP-1表达情况、宫颈长度进行比较,分析其对早产的诊断价值。结果早产组孕妇宫颈黏液中phIGFBP-1阳性率显著高于足月产组,差异具有统计学意义(x^2=9.874,P=0.002)。phICFBP-1阳性组孕妇28~32周内分娩率显著高于phIGFBP-1阴性组,差异具有统计学意义(x^2=7.513,P=0.006)。phIGFBP-1阳性组孕妇33~37周内分娩率显著高于phIGFBP-1阴性组,差异具有统计学意义(x^2=12.300,P=0.001)。早产组28~32周、33~37周宫颈长度均显著低于足月产组,差异具有统计学意义(t值分别为5.154、4.145,均P<0.015)。使用孕妇宫颈黏液中phIGFBP-1联合宫颈长度诊断早产阳性预测值(67.7%)、准确率(78.1%)均高于单独使用phIGFBP-1、宫颈长度诊断。结论 phIGFBP-1、宫颈长度可作为早产预测指标,联合诊断可以提高早产的阳性预测值和诊断的正确性。

Objective To investigate the diagnostic value for predicting premature delivery by high phosphorylation insulin-like growth factor binding protein 1 （phIGFBP-1） and cervical length. Methods From June 2013 to December 2014 96 high-risk pregnancy women at gestational 28-37 weeks admitted in department of.gynecology and obstetrics were selected from the First Affiliated Hospital of Huzhou Teachers College, and they were divided into preterm group （32 cases） and full-term group （64 cases） according to pregnancy outcomes. Results Positive rate of phIGFBP-1 in the cervical mucus of preterm group was significantly higher than that of full-term group （X2 = 9. 874, P = 0. 002）. Compared with phIGFBP-1 negative ,group, delivery rate during gestational 28 -32 weeks was significantly higher and that during gestational 33 - 37 weeks was also remarkably higher in phlGFBP-1 positive group of preterm cases （A2 value was 7. 513 and 12. 300, respectively, and P value was 0. 006 and 0. 001, respectively）. The cervical length of cases at gestational 28 -32 weeks and 33 - 37 weeks of preterm group was significantly shorter than that of full-term group （ t value was 5. 154 and 4. 145, respectively, both P 〈 0. 05）. Joint use of phlGFBP-1 in cervical mucus and cervical length in diagnosis of premature delivery had higher predictive value （67, 7% ） and accuracy （78.1%） than single phIGFBP-1 or cervical length. Conclusion PhIGFBP-1 and cervical length can be used as indexes to predict premature delivery, and joint diagnosis can improve the positive predictive value and accuracy.